Asbestos project notification form, 45 Wall Street

NYC 9/11 Public Portal Document

a_, AS Ir flf101itJTfl t sro INSPECTION REPORT (continued) 1*j*u i . I 334 Tel.# (718) 273-0428 ..

26. Asbestos Hauler E.W.N.S. NYS DEC Permit # 2

Disposal Site(s) ATHENS HOCKING RECLAMATION RTE. 33 BOX 946 LOGAN, OHIO 43138

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) 0 Sprinkler Replacement d) 0 Renovation/Alteration e) 0 Fireproofing Replacement f) ❑✓ Other (Describe) EPA INDOOR AIR QUALITY CLEAN UP _____________

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application SCOPE "B'

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, dedcin , etc.) FEET FEET removing and replacing boilers, etc.)

25 APARTMENT 2502 ALL SURFACES 920 SCOPE "B"

9 APARTMENT 902 ALL SURFACES 789 SCOPE "B"

5 APARTMENT 506 ALL SURFACES 790 SCOPE "B"

3 APARTMENT 318 ALL SURFACES 810 SCOPE "B"

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.

CO CONSULTANTS JBH ENVIRONMENTAL, INC. JBH ENVIRO ENTAL, INC. Pn t Name of Ap licant ( ther than Owner)

c . Print Name of Air Monitor Print Nam bestos Contractor

Signature V&%.nature Sig ature

(f/ 27 o v Date 11 Z , ate i ( ZZ ___ Dale

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 c tracted the thjrd party air monitor who is completely independent of all parties involved in th asbestos pro' I. I hereby d re that I have thorize the filing of this notification for the work specified herein. USEPA FOR OWNER — f ~ % = Print Name of Owner Signature Date

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

I Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. I 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 ?!2001

NYC-WTC 000112388