NYC-WTC_000111229
NYC DEP Asbestos Project Notification form for inspection report submission.
8 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.999
machine-extracted · confidence unavailable · Check page ↗Document / 28 pages
Asbestos Project Notification form, Nassau Street
Machine-extracted title · confidence 95%NYC DEP Asbestos Project Notification form for facility at Nassau Street.
NYC-WTC_000111346–000111373Folder label: “Zone I Copies”
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NYC 9/11 Public Portal Document
)( Li NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8'" Floor. Corona, NY 11368-5107
l ONLY TYPEWRITTEN DAP T .. nc~~ ASBESTOS PROJECT NOTIFICATION FORMS WILL BE (ASBESTOS INSPECTION REPORT) ACCEPTED w ^.y< s.• 4.r,
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 =11M A O EN _1 AlJ E ----N---! _ Borough MAIJ ---- Zip _ i 0038
AKA ----__---_ —_ — --_ 3. Block 65 4. Lot 10
5. Type of Facility___---__ -- - -- -- 6. Name of Building
II. BUILDING OWNER
7. Name _«I0WARD —t_ t I= Sit 1TZ-- _ 8. Contact Person
9.Tel.# _(212►6T3- 2300 -- __Fax #
10. Address City State _--_ Zip
Ill. GENERAL CONTRACTOR
11. Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name BEwMA %&I VUa:Z4SA~.t t I!_E -----_13. Contact Person _Losi4E_ I A00tCC
14. Federal Employer ID. #; PII ~ __ 15. Tel. # Cri9) 53i - 290o Fax # CTr6) 2c9- itAB
16. Address 124$ 2A~.PN A\Mw -- City B State L. Zip _1LL arc _.
V. THIRD PARTY AIR MONITOR
17. Name _WP"E 4 PAta-ZER ENG.ratE¢s _--- _18. Contact Person MtO4AE NC_LA►~
19. Federal Employer ID. # PII _ 20, Tel. # C2I2~ 922- 00-IT __— Fax #
21. Address 2fS EAS ;_ AS rA S' -------City Ntac12 ____ State /.;Y _ Zip IicotT
22. Sample Analysis Laboratory__--. 23. NYS DOH ELAP #
VI. PROJECT INFORMATION 24_ Starting date for this portion of work o910 s i o•2-- Projected completion date
Asbestos work schedule ® Monday 0 Tuesday ® Wednesday ® Thursday 0 Friday 91 Sunday ez: Shift from: — Ia am ❑ pm to _ P __ ❑ am l I 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
_. 1Q.52 Square Feet, and/or _.a_ Linear Feet
..i
NYC-WTC 000111356
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NYC-WTC_000111356Source: NYC Law Department, mirrored locally
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Asbestos inspection report form and project notification to NYC Department of Environmental Protection requiring original and three copies.
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