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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

,1094 wr~~,. • '_.. kr NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8"' Floor. Corona. NY 11368-5107 8ui1dng0 or TRtYNo ONLY ,. ®~1I — ) 1 FOR OFF . USE ONLY TYPEWRITTEN ~<o.,_ 4/ ASBESTOS PROJECT NOTIFICATION FORMS WILL B " O -- (ASBESTOS INSPECTION REPORT) 1.4ee~te~e When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original signatures are required. Submittal at (he 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 53 Nassau Street 2.Address Borough Manhattarizip 10005 AKA 3. Block 64 4. Lot 5 5. Type of Facility__ 6. Name of Building _ II. BUILDING OWNER

7. Name Century Realty, Inc. 8. Contact Person

9. Tel. # 212-267-7778 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. # 15. Tel.# 7188-961-4100 Fax# 718-961-4103 16.Address 14_20 129th Street CityCollege Point State NY Zip 11 356 V. THIRD PARTY AIR MONITOR

17. Name Warren & Panzer Engineers, P.C. _18_ Contact Person Michael Nolan 19. Federal Employer ID. # 20. Tel. # 21 2-922-0077 Fax 212-922-0630 228 East 45th Street Ciry New York 21.Address 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 7 3 oy • Z Projected completion date 7J8 Asbestos work schedule Monday <t!I Tuesday n WednesdayZThursday riday ' Saturday (Sunday

Shift from: am ❑pm to Dam

If other. specify of 4 Access to inspect the premises must be provided during the work schedule indicated in this item. RECENED I 0 JUL 05 2002 25. Total amount of asbestos-containing material to be abated during this work 0EP/BANi , - SRESTDS/LEA r' R 1,200 fi1GM Square Feet. and/or Linear Feet 2 4 fZtiZ) 9. ~7 ACP 7 V2001

yc i/,/ NYC-WTC 000111473

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NYC-WTC_000111473Source: NYC Law Department, mirrored locally

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