Invoice for facade remediation services, July 2002

NYC 9/11 Public Portal Document

i ~/ lily' r ~j ciir o[r,~F NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION

ONLY D~P ~. , Asbestos control Program 59-17 Junction Boulevard, 8t1 Floor, Corona, NY 11368-5107 o3i ko . Building Dept. or TR FOR OFFICIAL USE ONLY No pONM[Nra~o~`co~ TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION FORMS WILL BE _ (ASBESTOS INSPECTION REPORT) ACCEPTED fee schedule) When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original 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 S~.—, 2. Address ----__ Borough —_L —L— Zip

AKA ---_ ---- —_ 3. l Bock 4. Lot ------------------- ----- ------- 5. Type of Facility_____-------- _-- _ --- 6. Name of Building II. BUILDING OWNER

Name — _C COI_- —____-- 8. Contact Person 1~$J5~ ZL

9. Tel. # Fax #

1D. Address —!l~Ct _tUIX5 l old S I City CMILL N State _N ` I -- -- — — —~ --- ~---- - 1 Z~iP ~'t ~-~t Ill. GENERAL CONTRACTOR

11. Name . Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name % (~_~iL (_ 1 Ic _13. Contact Person

14. Federal Employer ID. # _ Pit 15. Tel. # ~ 1 _ 75f °30o Fax #

16. Address 01~ 2&S..j /I/---__--- city ) /2 L -- _ State k( Zip _iL22_ _

V. THIRD PARTY AIR MONITOR po h f 17. Name ✓~ (~€ Dj_ krt 2 c D_ ( a r ~(E?? S fC 18. Contact Person ~L± L

19. Federal Employer ID. k PII 20. Tel. # _Q ( _1aa =mac - Fax # ZI — ~~a=Gr✓

21. Address ~ r_>~~~--/-- City ~ W -~z------- State Zip 00 22. Sample Analysis Laboratory-- S~'(ter ((~~C- G- 4 ~- ! 1?r- t S J c — 23. NYS DOH ELAP # _!J ____ VI. PROJECT INFORMATION

24.. Starting date for this portion of work _iO4 0 Projected completion date 1 7 Tr Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from: _—__ ❑ am ❑ pm to _—__ ❑ am ❑ pm

If other, 1, specify --------- -------------------------------- RE IMEO Access to inspect the premises must be provided during the work schedule indicated in this item. 2 2002 = Ji ll 0 EP/BANHM 25. Total amount of asbestos-containing material to be abated during this work EST PROGRAM Square Feet, and/or _ Linear Feet T T 2UG 6' / ACP7 1 P 2/2001

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NYC-WTC 000112781