NYC 9/11 Public Portal Document
44
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
4
Asbestos Control Program
59-17 Junction Boulevard. 8o Floor. Corona. NY 11368-5107
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TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION
FORMS WILL BE t- - (ASBESTOS INSPECTION REPORT)
ACCEPTED ! www.e,c.p♦ ae~ 1.
(See fee schedule)
When submitting this form at the NYC Department of Buildings. the original form and three (3) copies with original
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.
I. FACILITY
26 Wall Street BorougtP
anhattan
Zip
10005
2. Address
AKA 3. Block 4 3 4. Lot 6
5. Type of Facility 6. Name of Building
II. BUILDING OWNER (Ve SlPl
7.Name United States Dept. of Interior 8.ContactPerson
9. Tel. # 212-825-6990 Fax# *
10. Address City State Zip
I11. GENERAL CONTRACTOR
11. Name- Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12.NameTrio Asbestos Removal Corp. ___-13.ContactPerson Chris Horan
14. Federal Employer ID. # P11 -15. Tel. #718-961 -41 00 Fax#71 8-961-41 03
16.Address 14_20 129th Street CityCollege Point State NY Zip 11 356
V. THIRD PARTY AIR MONITOR
Warren & Panzer Engineers, P.C. Michael Nolan
17. Name 18. Contact Person
19. Federal Employer ID. # 20. Tel. #21 2-922-0077 Fax# 212-922-0630
21. Address 228 East 45th Street City New York StateNY Zip 10017
22. Sample Analysis Laboratory Warren & Panzer Engineers, P. 23. NYS DOH ELAP #1 1 2 51
V1. PROJECT INFORMATION
24. Starting date for this portion of work /7/ Projected completion date
Asbestos work schedule 0 Monday ❑ Tuesday 0 Wednesday ❑ Thursday 0 Friday 0 Saturday 0 Sunday
Shift from: —__❑am ❑pm to Dam ❑pm
If other,
specify
Access to inspect the premises must be provided during the work schedule indicated in this item..
25. Total amount of asbestos-containing material to be abated during this work
53,91 0 . Square Feet, and/or Linear Feet
'7
31
NYC-WTC 000111225
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