Asbestos Project Notification form, Oct 2001

NYC 9/11 Public Portal Document

00 +a, utr rw~, OF ENVIRONMENTAL PROTECTION • ' +, I ti, ; Asbestos Control Program 59-17 Junction Boulevard, 8'" Floor, Corona, NY 11368-5107 N1 Building Dept. or TRU No A D FOR OFFICIAL USE ONLY ONLY TYPEWRITTEN •~, ~ /` ASBESTOS PROJECT NOTIFICATION FORMS WILL BE 'O"& .N!~!j1O ' (ASBESTOS INSPECTION REPORT) ACCEPTED +..rc.sa.roco 1• See teeschedule) 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 NYCOEP 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 _ 49 Broadway —_ — BoroughManhattan Zip_ 1 0006 AKA_ — _25 Trinity Place —3. Block 20 4. Lot 13 5. Type of Facility_— 6. Name of Building

II. BUILDING OWNER rn 'C Cl 7. Name Stahl Midtown Property 8. Contact Person 2"1Z C4 Zc 5000 9. Tel. # 212-425-5000 Fax# 10. Address City State Zip

III. GENERAL CONTRACTOR

11. Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. NameTri n AshAst- nc Removal Cr rp - -- 13. Contact Person Chris Horan

14. Federal Employer ID. # - _P-- _ 15. Tel. # 7L&- 61- 41 OQ_ Fax 971 A - 9 61 - 41 0 3

16. Address _1 4_ 2 0 1 2 9th S LXjae t __ City c 1 1 eg PQip.,t__ State NY Zip_U.356

V. THIRD PARTY AIR MONITOR

17. NameWarren & Panzer Engineers, P.C. --- 18. Contact PersonKi-chael Nolan

19. Federal Employer ID. # 20. Tel. #212-922-007 Fax # 212-9220630 21.Address2 28 East 45th Street _city New York Staten _Zip10017 22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 1 1 251 —__

VI. PROJECT INFORMATION 24. Starting date for this portion of work __/r) /O2 Projected completion date 7 (JJa2'

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

Shift from: ____Dam ❑pm to Dam ❑pm i " ` 1\ If other, p 4, specify _—_-- ----- I\ [CCEIVEU 1 i

Access to inspect the premises must be provided during the work schedule indicated in this item. ! -' 1u N ^ C 2002 U U nPlN' ti 25. Total amount of asbestos-containing material to be abated during this work ` S'GSL_-. ~GGPar: 0 . Square Feet, and/or Linear Feet TPUG N ~ /. ACP 7 ~G Z 211001

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NYC-WTC 000111481