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Document / 4 pages

Asbestos project notification form header, Oct 2001

Machine-extracted title · confidence 90%

Department of Environmental Protection asbestos inspection report notification form with submission instructions.

NYC-WTC_000111500–000111503

Folder label: “Zone III Originals

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Scanned page image, NYC-WTC_000111500
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NYC 9/11 Public Portal Document

-~" D6o Gtr C~ NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program

% TYPEWRITTEN ,`':h~ - ~._.._. FORMS WILL BE ='r'^"~ t:4 ~% ) 59-17 Junction Boulevard, 8"' Floor, Corona, NY 11368-5107

ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) Bulding Dept, or TRU No Foao tcw ust=ol+tr

ACCEPTED *•w.•r<.:••la<o 1, (S ee schedule) When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with origin/ 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 .

I. FACILITY

2.Address 30 Wall Street Borouglanhattan zip 10005 AKA 3. Block 43 4. Lot .5 5. Type of Facility_ 6. Name of Building II. BUILDING OWNER

7. Name 30 WSLLC C/o The Pyne Companies 8. Contact Person 9. Tel. # .21 2-425-0588 Fax# 10. Address City State Zip III. GENERAL CONTRACTOR

11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name Trio Asbestos Removal Corp. 13. Contact PersonChris Horan 14. Federal Employer ID. P11 15. Tel. #718-961-4 1 00 Fax # 718-96 1 410 3 16.Address 1 4-20 129th Street cityCollt9e 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 ID. # 20. Tel. 212922 _0077 Fax# 212-922-0630 21.Address 228 East 45th Street city New York State NY Zip 10017 22. Sample Analysis LaboratoryWarren & Panzer Engineers 23. NYS DOH ELAP # 11251 VI. PROJECT INFORMATION 24. Starting date for this portion of work Projected completion date 7

Asbestos work schedule fbnday Tuesday SWednesday Thursday [ Friday Saturday "Sunday

Shift from: 2 $am ❑pm to Dam pm

Ifother,

specify _____________________________________________________________ 7/7 ^ hAwfl

Access to inspect the premises must be provided during the work schedule indicated in this

25. Total amount of asbestos-containing material to be abated during this work 1 2, 275 item.1 (c N ,~tfN 1~~[[

JPRI)RAM 2

A: 7 2002 N Square Feet, and/or Linear Feet ACP 7 212001

NYC-WTC 000111500

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NYC-WTC_000111500Source: NYC Law Department, mirrored locally

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