NYC 9/11 Public Portal Document
P.a4
TUN-19-2002 13:26
ECTION REPORT (conti
ASBESTOS INSP Asbestos Teanstertation — 1k2371 TEL# 631-924-5050
26. Acbestos Hauler a... NYS OGC Permit 4 ;
Disposal Site(e) I@Perial/POB 47, 11 Boggs Rd. 1 PA; Southern Alleghenies/rd 3
Box 310, Valleyview, Ba
27. This asbestos abatement is part of a (Item a through e requires filing of this foem with NYC Department of Buildings)
a} £7 Gemotition t) C7 oiler Reptacement ¢) £7 Sorincter Reptacement 70 Renovation/Atteration
9Q Fireproofing Repiscement C2 Other (Describe) :
28. TYPE OF ABATEMENT (Check ait appropriate boxes)
Cj Removat QO Enclosure QO Encapsulation (J Repair O ciean up
29, ABATEMENT PROCEDURE (Chack all appropriste. boxes)
Full Containment CJ. Giovebag ag Tent | OSP Variance Application
OF,
INO 2
30. LOCATIONS OF ABATEMENT
: OESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BE:
Floor(s) OF FLOOR CONTAINING AGM PERFORMED
(0.9. entire, east wing, toom #, (6.9. Pipe mgging, cating, plenum | SQUARE uNtAR {€.9. running cabie, instating fire sprinklers,
. lobby. . CIBAKS. detking, ete) | FEET FEET ing and ro boilers,
Roof [item No. 3 11,565
Walls] Item No. 8 3,638
PennNet fp tod CH
Air Shaft
oof Item No. 3 1,50
Walls! Item No. 3 24,105
31. Chereby dociare that the information provided herein ic sue and complete ta the best of my knowledge. | am tamiliar with Federal,
State and NYC laws and regulations applicable to asbastas related work,
Warren & Panzer Trio Asbestos Removal NYC
Print Name of Ar Montor Prt of Contractor, Print Name of CTother tan Owner
LELk la i, (a oP “CE
P ‘Sigeoture Signature
Sis fon ! CHILD |
Sate Le Date
32. | understane that as the owner of a building where asbestos abatement activity occurs, | am responsible for the Pertormance of
the asbestos abatement activities in accordanca with the Asbestos i; Program Rules. i have contracted the third party air
as
Monitor who is completely independent of alt parties involved yfPhe jetes project. | hereby declare that ! have aysharized the
A (Ad, DEP e oof»
ture %
filing of this notification for the wark specified herein,
120 Liberty str. LLC c/o Nyc
Print Name of )
NYC-WTC_000111491
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