Asbestos Project Notification form, Oct 2001

NYC 9/11 Public Portal Document

V rxr-R em NYC DEPART ic F ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard. 8r' Floor, Corona, NY 11368-5107 > Wilding Dept. or TRU No ONL'Y 1~ FOR OFFICIAL USE ONLY (I , TYPi"ITTEN ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) 1. ..~• , yc.:n.::.► "ACCEPTED Vt

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 52 WIILIAM STREET Borough Manhattan Zip—. AKA 47-49 PINE STREET, CLUB QUARTERS 3. Block 4. Lot

5. Type of Facility__—____ _—__—_—__ ___ 6. Name of Building II. BUILDING OWNER

7. Name FINANCIAL DISTRICT ASSOCIATES LLC do MAST 8. Contact Person 212 626-9392 9. Tel. # ----------- - Fax # —_—__—__—__ ----- _______

10. Address ------------------------------ City --------------------- State ----- Zip ---------

III. GENERAL CONTRACTOR 11 _ Name Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name TRIO ASBESTOS CORP. REMOVAL--------------------- STEVEN PARMIGIANI 13. Contact Person ----------------- ------------- 14. Federal Employer ID. # L___- __ ____—__ 15. Tel. # (718) 961 _1 _______._ Fax # 718 961-4103 -------------- 16. Address 14-20 129 STREET - City COLLEGE POINT —_- State NY - zip 11356 _—

V. THIRD PARTY AIR MONITOR

17. Name WARREN & PANZER ENGINEERS, P. C._- -_----_- - _ - 18. Contact Person MIKE NOLAN

19. Federal Employer ID. # _____ ______ 20. Tel. # (212) 922----- --_-- Fax # (212) 922-0630 --

21. Address 228 EAST 45ty STREET —_ ---__-- City N_Y___-__--_ —_ —__ State NY-- Zip 10017

22. Sample Analysis LaboratoryWARREN & PANZER ENGINEERS_ P _C._____-- 23. NYS DOH ELAP # 111251 VI. PROJECT INFORMATION 24. Starting date for this portion of work _ _ L0 Z Projected completion date _— /L.2..JI I )

Asbestos work schedule 0 Monday 0 Tuesday 9 Wednesday 0 Thursday 0 Friday 0 Satulday-QSunday

Shift from: 8:00 __ ❑✓ am 0 pm to $_~~ 0 am 0 pm In 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 __ 3,940 Square Feet, and/or —_—_—_ 0 Linear Feet

ACP 7 2/2001

NYC-WTC 000111376