Invoice for roof cleanup services, Dec 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler ASBESTOS TRANS. CO. NYS DEC Permit # 1A-371 Tel.# (631) 924-5050 SOUTHERN ALLEGHANIES- VALLEYVIEW DR., PA. Disposal Site(s) IMPERIAL- P.O. 47, 11 BOGGS RD., PA. /

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) 0 Other (Describe)

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment 0 Glovebag

30 LOCATIONS OF ABATEMENT 0 Tent 0 DEP Variance Application 1~9a I ~)C)'A--- DESCRIBE SECTION.. AFFECTED SURFACES AMOUNT OF ACM. DESCRIPTION OF. WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable. installing fire sprinklers, (e.g. entire, east wing, room #, boiler room lobby,etc duct storage tanks, deckin etc.) FEET FEET removing and mpladng boilers, etc.)

ROOF MAIN ROOF' ASPHALT ROOF,DUNNAG 3,350 ITEM #2

ROOF SETBACK GRAVEL ROOF 600 ITEM #4

ALL FACADE WINDOWS, LEDGES 6,056 ITEM #8

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.

WARREN & PANZER ENG., P.C. TRIO ASBESTOS REMOVAL STEVEN PARMIGIANI Print Name of Air Monitor Print Name of Asbestos Contractor Print Name of Applicant (U other than Owner)

Signature r/ ljSignature ignature

Y61 3.qlo'> - Data 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.

Print Name Owner 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. ACP, yp0pt

NYC-WTC 000112184