Asbestos Project Notification form, Oct 2001

NYC 9/11 Public Portal Document

rr NYC ~T tUF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard. 8" Floor, Corona, NY 11368-5107 "((a4OMN Buadin Dept. or TRU No FOR OFFICUL use ONLY TYPEWRITTEN ~';ti`y•. a,p /j ASBESTOS PROJECT NOTIFICATION FORMS WILL BE (ASBESTOS INSPECTION REPORT) ACCEPTED i .. is.T.. ., ;

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 .

1. FACILITY

2. Address 22 Maiden Lane Borougl anhattan Zip 10005

AKA 3. Block 64 4. Lot 2

5. Type of Facility__ 6. Name of Building II. BUILDING OWNER

7. Name Windsor Place Corp. 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 ID. # . P11_._._._. 15. Tel. # _?i. .2. 1 - 4100 Fax # 71 8 - 9 61- 410 3 16.Address 1 4_20 1 29th Street CityCollege Point State NY Zip 11 356 V. THIRD PARTY AIR MONITOR Warren & Panzer Engineers, P.C. Michael Nolan 17.Name 18. Contact Person

19. Federal Employer ID. # 20. Tel. # 21 2-922-0077 Fax # 21 2-9 22-0630 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 24. Starting date for this portion of work I1 I `~ ' " Z" Projected completion date / Asbestos work schedule onday ir sday (~-GVednesda Thursday riday~-Saturday ridgy

Shift from:

If other, c~ D %M p 0 to Dam 6 ~ y .,_

4 J. 3 .

4 ~ specify _ RE {~ ivED Access to inspect the premises must be provided during the work schedule indicated in this item. ~ JULU 11 8 2002 -e,IgANk-, 25. Total amount of asbestos-containing material to be abated during this work . TgCa4m ' 260 s Square Feet, and/or Linear Feet IC 1Z ACP 7 2n0o1

c, NYC-WTC 000111467