Asbestos Project Amendment form, Oct 2001

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY j ay 4. Asbestos Control Program Fee (It any) $ `~ ; Dtip 1 59-17 Junction Boulevard, 8" Floor, Corona, NY 11368-5107 ONLY TYPEWRITTEN FORMS WILL BE~~°'=` ASBESTOS PROJECT AMENDMENT FORM Amendment ~A ";Ca/7 Information Only: 0 Yes ❑ No ACCEPTED .•.ert.ra./o.c FOR FORM ACP 7 (v A modification is valid only if it is received by the NYCDEP prior to the previously filed date of ..f / completion, except for start date changes that must be received by the original start date. ( ~ 1/1 (,~ ///"` ✓✓~~

ACP7 U/BN# O M cility Address W ( D 06O ` Borough Zip Date ACP7 was filed '7/0 - Variance # (if any) Was this ACP7 amended before? Yes 0 No If yes, specify date

Original Start Date D riginal Completion Date Oifrom ACP 7, #24. PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified no more than twice. Only the building owner may amend items IV and V. The original applicant or building owner may amend all other items. IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name A I 13. Contact Person t Of { C cS I' P ( 14. Federal Employer ID. # ` ' 15. Tel. # 1b) 7&i —3~ax a ►6' — ~v' O~ nn A 16. Address 01 f 1-¢- fl-- City ~nl-Pr-t1'~'Are.t 1* State _Zip

V. THIRD PARTY AIR MONITOR

17. Name Q_ 1 n11r P~rnl .~ C.~K;~..~i'fc~18 , f tom. 18. Contact Person LPL) C..Lc

19. Federal Employer ID. # 20. Tel. # oo'fl Fax # _ c1~ 21. Address 1 __________State City fJ ` 'N' 'Zip -1 ~1 — r -- 22. Sample Analysis Laboratory tJ2 C. oR1t C33. NYS DOH ELAP # l\ ~~

VI. PROJECT INFORMATION ❑ Project Cancelled ~1 24. Starting date for this portion of work ~- 0 ~`' Projected completion date °— ❑ Project Postponed

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

Shift from: ❑ am ❑ pm to ❑ am ❑ pm If other,

25. Additional asbestos-containing material to be disturbed during this work l "/ t Feet Reduction in the amount of ACM to be disturbed during this work Feet QJG2~ L 29. Abatement Procedure for Additional Material (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag 0 Tent 0 DEP Variance Application

Other Changes - \"

30. Locations of abatement modified by above e_-s -- (For each floor list ACM ad )

31/32. Name of Applicant / Owner quantitRX", r--O- Tel.

Name of Company (If any) 1" 1 1 Fax # Address City State Zip

I hereby declare that the information provided herein is true and complete. -,A .p 2_._

Sign ture of Applicant /Owner Date oco ACP6 REfU Of fMMo*~ 1ROl to,7

NYC-WTC 000111334