Document header page for 20 Vesey Street records, Jan 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler DJM, Inc. __

NYS DEC Permit # JA_344 _ Tel.# (201) 656-8889 Disposal Site(s) Greenidge Reclamation - RD #1 Box 716 Landfill Road Scottdale, PA 15683

27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement f) El Other (Describe) Emergency Response Cleanup

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair El Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag El Tent ❑ DEP Variance Application

30. LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, boiler room, lobby, etc) ducts, storage tanks, decking, etc.) FEET FEET removing and replacing boilers, etc.) 10th Mr. Lustig's Office Dust on window sills 10 Cleanup of dust from window sills

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

R. A. West Associates ACSI ACSI Print Nam of Air Monitor Print a of A estos Contrac Print Name o Ap 'cant (If other than Own )

Signature Si nature Sign ure

11/26/01 11/26/01 11/26/01 Date —Date ----- Date

32.I understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for the performance of the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have contracted the third party air monitor who is completely independent of all parties involved in the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified herein, Richard Rubel c/o Cedar Management Corp. Print Name of Owner r% cL rJJ 6 11/29/01 Signature Date

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the performance of work in incremental or piecemeal fashion, ACP7 212001

NYC-WTC 000112115