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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 ptt sae NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION 4y . arty Ofrag se. 4 ' “ee Asbestos Control Program 4 Be O q ov 4 O , P) \ 59-17 Junction Boulevard, 8" Floor, Corona, NY 11368-5107 Building Oept ott RN ONLY y. / FOR OFFICIAL USE ONLY TYP. Mx... ASBESTOS PROJECT NOTIFICATION . “neat HON (ASBESTOS INSPECTION REPORT) A wi a "wawaye.govldep ) 1. {Gee fee schedule) v When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with Original signatures are required. Submittal at (he 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 : 2. Address 63 Wall Street Boroughanhattan Zip 10005 AKA 3. Block 27 4. Lot 9 5. Type of Facility 6. Name of Building ll. BUILDING OWNER 7.Name BEOwn Brothers Harriman 8. Contact Person 9. Tel. # 212-493-8616 Fax # : 10. Address City State Zip Ill, GENERAL CONTRACTOR 11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR 12. Name Trio Asbestos Removal Corp. 43. Contact Person Chris Horan 14, Federal Employer (0. # Lennnnaal oo 3 15. Tel. # 718-961-4700 Fax # 718-961-4103 16. Address 14-20 129th Street city College Point State NY Zip 11356 V. THIRD PARTY AIR MONITOR 17. 19. Federal Employer ID. # 20. Tel. # 21.Addresg 228 East 45th Street city New York StateNY 22. Vi. PROJECT INFORMATION Starting date for this portion of work 6 | 27 ot Projected completion date | se o* 24. 25. Total amount of asbestos-containing material to be abated during this work Warren & Panzer Engineers, P.C. 18. Contact Person Michael Nolan 212-922-0077 212-922-0630 Fax # 2ip1 0017 Name Warren & Panzer Engineers 23. NYS DOH ELap #11251 Sample Analysis Laboratory. Asbestos work schedule [ Monday O Tuesday O Wednesday O Thursday O Friday O Saturday | O Sunday Shift from: § Bim Clpm to g Olam Bp ‘ If other, specify Access to inspect the premises must be provided during the work schedule indicated in this item. 3,000 — Square Feet, and/or Linear Feet NYC-WTC_000111494

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NYC-WTC_000111494Source: NYC Law Department, mirrored locally

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