Asbestos Project Notification Form, DEP Box 39

NYC 9/11 Public Portal Document

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an ousy~'\ NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8"' Floor, Corona, NY 11368-5107 Building Dept. or TRU No ONLY i D^rP ,) FOR OFFICIAL USE ONLY

TYPEWRITTEN ~` . ./~ ASBESTOS PROJECT NOTIFICATION FORMS WILL BE . - (ASBESTOS INSPECTION REPORT) ACCEPTED 1_ ww.l ►t.(w af,

(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

2. Address 49 Broadway BoroughManhattan zip_ 10006 AKA 25 Trinity Place 3. Block 20 4. Lot 13 5. Type of Facility 6. Name of Building II. BUILDING OWNER h„ . I_C. n f

7. Name Stahl Midtown Property 8. Contact Person 21Z L4 lc S000 9. Tel. # 212-425-5000 Fax# 10. Address City State Zip III. GENERAL CONTRACTOR

11. Name_—_________________ Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. NameTrjo Ah gtng Ramnva 1 C11rp 13. Contact Person Chris Horan 14. Federal Employer I0. # ._._._._._._.PII 15. Tel. # 718-961-4100 Fax # 71 8 - 9 61 - 41 0 3 16.Address 14-20 129th Street _City('alleg Point State NY Zip11356__ V. THIRD PARTY AIR MONITOR

17. NameWarren & Panzer Engineers, P.C. 18. ContactPersonMichael Nolan 19. Federal Employer ID. # 20. Tel. # 21 2-922-007 Fax# 212-922-0630 21. Address 228 East 45th Street city New York StateNY zip1001 7 22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 1 1 251 VI. PROJECT INFORMATION 24. Starting date for this portion of work _/162— Projected completion date '7

Asbestos work schedule 0 Monday 0 Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from: ____Dam ❑pm to Dam ❑pm

If other, specify _

Access to inspect the premises must be provided during the work schedule indicated in this item. 1 25. Total amount of asbestos-containing material to be abated during this work

1 5.51 0 . Square Feet, and/or Linear Feet

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NYC-WTC 000111226