WTC debris inspection form for World Financial Center, 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler Asbestos Transportation Corp. NYS DEC Permit # 1A-371 Tel.# (631) 924-5050 Bridgeport, WV 26330 Disposal Site(s) Meadowfill Landfill, Buildings) 27. This asbestos abatement is part of a (Item a through a requires filing of this form with NYC Department of b) 0 Boiler Replacement c) ❑ Sprinkler Replacement d) 0 Renovation/Alteration a) ❑ Demolition Asbestos Abatement e) ❑ Fireproofing Replacement 0 0 Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) 0 Removal 0 Enclosure 0 Encapsulation ❑ Repair 0 Clean up

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application -- --------

U. LUGAl1UNYD yr Pwj%i Emcn i --n. ia ESCRIPTION OF WORK BEING DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM CONTAINING ACM PERFORMED Floor(s) OF FLOOR SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room *, (e.g. Pipe lagging, ceiling, plenum ET FEET removing and repladng boilers, etc.) boiler room, lobby, etc) ducts, storage tanks, decking, eta) **see attached

knowledge. I am familiar with Federal, 31. I hereby declare that the information provided herein is true and complete to the best of my State and NYC laws and regulations applicable to asbestos related work.

EMTEQUE Don Adler for afeway Env Corp. Don Adler for Sa ay Env Corp. Print Neme st s Contractor Print Pa of Appli t (10th than Owner) P 'nt Name r Monitor

ig re lure Signature

10/8/01 10/8/01 10/8/01 Date Date Date

am responsible for the performance of 32. I understand that as the owner of a building where asbestos abatement activity occurs, I the asbestos abatement activities in accordance with the Asbestos Control Pr m Rules. I have contracted the third party air oject. I hereby declare that I have authorized the monitor who is completely independent of all parties involved in the asbe filing of this notification for the work specified herein. 10/8/01 ~au~ ZroaS~} as aAtant .{w NNeJJrun l:>~rrss gnature Date Print Name of Owner AVAILABLE AT THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE to the NYC DEP ACP. Any modification of information provided on this form must be reported immediately in writing directly lessened The requirements of the Asbestos Control Program Rules may not be lawfully avoided or through the performance of work in incremental or piecemeal fashion. AcP7 tizoot

NYC-WTC 000112025