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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

3/ W I / Jv ;r a Nrr . ~y~ " MY RTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8'" Floor, Corona, NY 11368-5107 Building Dept. or TRU No 1~rp J) TYPEWRITTEN `'!ey. FORMS WILL BE a` ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) FOR OFFICIAL USE ONLY

ACCEPTED - +~.erc.se.la<o ) 1 fee 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 26 Wall Street Borougt anhattan Zip 10005

AKA 3. Block 43 4. Lot 6

5. Type of Facility 6. Name of Building

II. BUILDING OWNER L) &ve uo Sl 7. Name United States Dept. of Interior 8.ContactPerson 9. Tel. # 212-825-6990 Fax#

10. Address City State_____ Zip

III. GENERAL CONTRACTOR

11 Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. NameTrio Asbestos Removal Corp. 13. Contact Person Chris Horan

14. Federal Employer ID. 4 PI 15. Tel. #718 - 9 61 - 41 0 _ Fax #718-961 -41 03 16. Address - 14-20 1 29th Street cilyCollege Point . State NY Zip 1 1 356

V. THIRD PARTY AIR MONITOR

17. Name Warren & Panzer Engineers, P.C. Michael Nolan 18. Contact Person 19. Federal Employer ID. # 20. Tel. #212-922-0077 Fax# 21 2-922-0630 21. Address 228 East 45th Street City New York StateNY Zip 10017

22. Sample Analysis Laboratory Warren & Panzer Engineers, P. 23. NYS DOH ELAP #1 1 251

V1. PROJECT INFORMATION

24. Starting date for this portion of work I7j Projected completion date

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

Shift from: __ Dam ❑pm to Dam ❑pm Cn \ 6 J

If other, specify -.

Access to inspect the premises must be provided during the work schedule indicated in this item. RECOVER JUN 1 7 2002 -~ 25. Total amount of asbestos-containing material to be abated during this work :1W ' JzJ 53,91 0 - Square Feet, and/or Linear Feet M yr ACP 7 \r il ` 2!2001

NYC-WTC 000111483

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NYC-WTC_000111483Source: NYC Law Department, mirrored locally

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