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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 £ 0 IE ct Binag NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION a ge ay Asbestos Control Program Atl O86 /#/120 59-17 Junction Boulevard, 8" . Corona, NY 11368-5107 8" Floor, Corona s Building Dept. or TRU No ASBESTOS PROJECT NOTIFICATION el (ASBESTOS INSPECTION REPORT) 1 Sz rl. (See fee sch&dute) ae OS" Sn W 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 . {. FACILITY 67 Greenwich Str./28 Trinity Pl. Manhattan_ 10006 2. Address Borough _ Zip AKA ; 3. Block _19 4.tot 11 5. Type of Facility. 6. Name of Building {l. BUILDING OWNER 67 Greenwich LLC c/o Martha Schessel g contact Person 7, Name 9. Tel. # 212-787-5932 Fax # 10. Address City State Zip Ill. GENERAL CONTRACTOR 11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR 12.Name Trio Asbestos Removal Corp. -13. Contact PersonChris Horan 14, Federal Employer 1D. # Pil 15. Tel. #7 18-961-4100 Fax # 718-961-4103 16. Address 14-20 129th Street cityCollege Point stateNY zip 11356 V. THIRD PARTY AIR MONITOR 17. Name Warren & Panzer Engineers, P.C. 18. Contact Person Michael Nolan 19. Federal Employer ID. # 20. Tet. #212-922-0077 Fax g212-922-0630 21. Address 228 East 45th Street city New York , State Y zip! 9917 22. Sample Analysis Laboratory Warren & Panzer Engineers 43 nysponeapye 11251 VI. PROJECT INFORMATION 24. Starting date for this portion of work IZ) Ly CZ Projected completion date Ch Asbestos work schedule () Monday O Tuesday O Wednesday O Thursday oO Friday O Saturday O Sunday Shift from: _ Olam Clem to Cam Clem If other, 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 10,815 . Square Feet, and/or Linear Feet we “Op, ba ee MAT Tui? Cg one a “NYC-WTC_000111488

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NYC-WTC_000111488Source: NYC Law Department, mirrored locally

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