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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 E04IWTC JUN-19-2002 13:25 EMERGENCY NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 semctian Bouievard, 80 Floor, Corona, NY 11389-5107 ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) P.01 ONLY DEP TYPEWRITTEN ! FORMS WILL BE ACCEРТEО соооотa 1110930MNOZ Guldro Dept or TRU Ne FOROFFICHL LEE OMLY 124C DET When zubmitling this form at the NYC Departmant of Buildings, the original form and three (3) copies with original signaluras are requirad. Submitlel al the NYCDEP requires one capy of the farm with orininat signalurez. This form must be submilled lo the NYC DEP nol less than ore waek in advance of the star el abalemoni acivitles. 1 FACILITY 2. Address 114 Liberty Str./119 Cedar Str. AKA 5. Typo of Faciiiy.. Il. BUILDING OWNER 7.Name Building Owner/Manager 9. Tel.# -Fax# 10. Address City i11. GENERAL CONTRACTOR 11. Name _ GoroughManhattan zip 10006 -3. Block 52 _4. Lot. 7502 6. Name of Bullding 8. Contact Person - State_ _ Zip IV. ASBESTOS ABATEMENT CONTRACTOR Tel.F. 12. Name Trio Asbestos Removal Corp. 14. Federal Employer ID.A PII 16. Address 14-20 129th street V. THIRD PARTY AIR MONITOR _ 13.Coniact Person Chris Horan -15. Tet.#718-961-1100 -Fax#218-961-4103 - Cifollege Point _ State NX _ Zip 11356 17. Name Warzen & Panzer Engineers, P.C. →__18. Contact Person Michael Nolan 19. Federal Employer ID. t _ 20. Tel. # 212-922-0077 _Fax#212-922-0630 21. Address 228 East 45th street City. New YoIk _ State NY 22. Sample Analysis Laboralary. warIen & Panzer Engineer$ -Zip!1251 _ 23. NYS DOH ELAP # 11251 VL. PROJECT INFORMATION 24. Starting date for this portion of work 6/5/02 Projected completion dale _ 6/30/02 Asbestoswork schedule fotmonday Tuesday Etfrednesday I muroay f Inday f sstuday & sunday snilarom: 8 otam Gom io 8 Mam Pilem lother. spocify eccess lo inspeclmne promisas must be proviakó during the work schedule Indicaltó in this item. 25. Total amouns of adgsios containing malerial la be abated during this work 20,005 - Square Feel, andlor. Linear Feet 42,425 a RECEVED JUN 20 2002 ЗАNн: -sEsTos.L. PROGRAM TRUG ACPY 22001 ASBESTOS CONTROL NYC-WTC_000111492

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NYC-WTC_000111492Source: NYC Law Department, mirrored locally

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