Asbestos Project Notification form, Oct 2001

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTN Asbestos Control Program

9 `' - ) 59-17 Junction Boulevard. 8th Floor, Corona, NY 11368-5107 Bung Dept. ac TRU No ON + DvY - FOR OFFICIALLoW Outy TY EN LL BE ~oj' - ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) L EO .....r~.r~•/s<o i 1. •

(See tee schedu1 ) When submitting this form a( the NYC Department of Buildings, the original form and three (3) copies with original signatures are required. Submittal at the NYCOEP 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.

1. FACILITY

2. Address 40 Exchange Place BoroughManhattan Zip 10004 AKA 27 William Street 3. Block 4. Lot 5. Type of Facility 6. Name of Building II. BUILDING OWNER

7. Name 8. Contact Person 9. Tel. # Fax # 10. Address City State Zip III. GENERAL CONTRACTOR

11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12.Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan 14. Federal Employer 1D. # P11 15. Tel # 718 9 61- 410 0 Fax# 71 8 9 61- 41 0 3 16.Address 14-20 129th Street cityCollege Point State NY Zip 11356 V. THIRD PARTY AIR MONITOR Warren & Panzer Engineers, P.C. 17.Name —18. Contact Person Michael Nolan 19. Federal Employer ID. # 20.Tel.# 212-922-0077 Fax# 212-922-0630 21.Address 228 East 45th Street city New York State NY Zip 10017 22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP f>` 11251 VI. PROJECT INFORMATION 24. Starting date for this portion of work •I v Z Projected completion date 3 _` ^~--

Asbestos work schedule -tom Monda Tuesday ednesdayl}"Fhursday riday~5aturda Sunday

Shift from: Pam ❑pm to L (]am' pm J 8 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 59, 060 Square Feet, and/or Linear Feet

2 ACP ?I20011

NYC-WTC 000111374