Asbestos Project Notification form, Oct 2001

NYC 9/11 Public Portal Document

1E j3o ` v t C~NY,C DEPARTMENT OF ENVIRONMENTAL PROTECTION '.,~N~ -- - '" " Asbestos Control Program - -'~ \ rl 5tJ-17 Junction Boulevard, 8"' Floor. Corona. NY 11368-5107 Building Dept. or TRU No ONLY FOR OFFICIAL USE ONLY . 4/ ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) iwww.n~c=e• aeo 1. (5 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 20 Broad Street _BoroughManhattan Zid0004 AKA 3. Block 23 4. Lot 50

5. Type of Facility__ 6. Name of Bui!ding II. BUILDING OWNER

7. Name 20 Broad Street Co., LLC 8. Contact Person

9. Tel. # 212-269-81 71 Fax #

10. Address _ City _ State Zip Ill. GENERAL CONTRACTOR

11. Name__ Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan 15. Tel. # 718-961-4100 Fax # 718-961-4103 16. Address 14-20 129th Street _ CityCollege Point _ State NY Zip 11356 V. THIRD PARTY AIR MONITOR

l7. Name _ Warren & Panzer Engineers, P.C. 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 # 11251 VI. PROJECT INFORMATION Q q Lc) 24. Starting date for this portion of work ul (fl Projected completion date I Z

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

Shift from: _____Dam ❑pm to Dam ❑pm

If other, specify _ 'b/ R~cc~vEO Access to inspect the premises must be provided during the work schedule indicated in this item.

A136 9 _ 202 25. Total amount of asbestos-containing material to be abated during this work 65, 633 Square Feet, and/or Linear Feet 'r,ur

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NYC-WTC 000111453