Asbestos Project Notification form, Oct 2001

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTIO `,,~. a~0 Asbestos Control Program / )I1vJ ONLY 7 ( ■ ■^ C•j' ^~ , ) 59-17 Junction Boulevard, 8'" Floor, Corona, NY 11368-5107 BuWing fkpt RU No FOR OFFtCW SE ONLY TYPEWRITTEN ~~~ CAj ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) -~~ (See fee schedule) When submitting this form a( 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 I form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities . I I. FACILITY

2. Address_ 106 Liberty Street —Borough Manhattan Zip 10006 AKA iU. 40V.5' Q t; eeka //2-//!{. /2.41.1 —F — 3. Block _ 4. Lot

5. Type of Facility 6. Name of Building 1I. BUILDING OWNER

7. Name II! Person

9. Tel.# Fax# ~~)) 10. Address 1000 L l -frW ~Q City >1_C1 State Zip Oo — Sds' V

III. GENERAL CONTRACTOR

11 Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan

14. Federal Employer ID. # P11 15. Tel. # 71 8 - 9 61 - 41 0 0 Fax # 71 8 - 9 61 - 41 0 3 16.Address_1_4-20 129th Street City College Point State_NY Zip 11 356 V. THIRD PARTY AIR MONITOR

17. Name Warren & Panzer Engineers, P.C. 18. Contact Person Michael Nolan 19. Federal Employer I0. # 20. Tel. # 212-922-0077 Fax# 212-922-0630 ' 21. Address 228 East 45th Street City New York StateNY Zip 10017 22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 11251 VI. PROJECT INFORMATION

24. Starting date for this portion of work Q3 02 Projected completion date

Asbestos work edule on ay Tuesday WFi sday f day ridgy Satarday~

Shift from: " r{, m ❑pm to ❑am,m a

RENED If other, specify _

Access to inspect the premises must be provided during the work schedule indicated in this item. AUG 0 1 2002 25. Total amount of asbestos-containing material to be abated during this work s =P ctNHr.. _ESTGSL -: ~RC~GAkt.r .R, 400 Square Feet, and/or Linear Feet TR2G

I10y Awi £I 7Zx vlool

NYC-WTC 000111457