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Asbestos Project Notification form, Oct 2001

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NYC DEP Asbestos Project Notification form for an inspection report submission.

NYC-WTC_000111453–000111499

Folder label: “Zone III Originals

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NYC 9/11 Public Portal Document NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8” Floor, Corona, NY 11368-5107 1103 Muah] Building Dept. or TRU No ASBESTOS PROJECT NOTIFICATION FOR OFFICIAL USE ONLY (ASBESTOS INSPECTION REPORT) 1. LY CD er (Sed-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 . 1. FACILITY AKA 5. Type of Facility. il. BUILDING OWNER 9. Tet. # (908) 753-6264 2. Address 110 Liberty Street / 113-117 Cedar Street Borough Manhattan Zip. 10004 3. Block 4. Lot 6. Name of Building ° 7. Name Baldwin Realty, c/o Charles Gangler 8. Contact Person Fax # City State Zip 10. Address iil. GENERAL CONTRACTOR Tel. # 11. Name iv. ASBESTOS ABATEMENT CONTRACTOR 12. Name Trio Asbestos Removal Corp. 43. Contact Person Steven Parmigiani 14. Federal Employer 1D. # V. THIRD PARTY AIR MONITOR Pil (718) 961-4100 (718) 961-4103 15. Tel. # Fax # 46. Address 14-20 129 Street City College Point State NY Zip 11356 Michael Nolan 17. Name Warren & Panzer Engineers, P.C. 18. Contact Person 19. Federal Employer ID. # 21. Address 228 East 45th Street Fax # (212) 922-0630 10017 20. Tet. # (212) 922-0077 City NY State NY Zip Warren & Panzer Engineers 23. NYS OOH ELAP # 11251 22. Sample Analysis Laboratory. Vi. PROJECT INFORMATION 24. Starting date for this portion of work _] ipl er Projected completion date _ 7/3 ok Asbestos work schedule pf Monday ANT uesday Et Wednesday “EI Thursday DFtiday D-saturday- Ef Sunday Shift from: a a] am QO) pm to a Olam pm If other, 31] 1% 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 NYC-WTC_000111471 _ 12,678 Square Feet, and/or_ 0 Linear Feet

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NYC-WTC_000111471Source: NYC Law Department, mirrored locally

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