Invoice for asphalt cleaning, Nov 2002

NYC 9/11 Public Portal Document

e d lid TL- Asbestos Control Program 59-17 Junction Boulevard. 8'' Floor. Corona, NY 11368-5107 .z( c//-rJ~ Bung OepL or TRU No FOR OFFICUL USE ONLY ASBESTOS PROJECT NOTIFICATION rr ip~ (ASBESTOS INSPECTION REPORT) 1. ~7 (See fee schedule)

When submitting this form at the NYC Department of Buildings. the original forth 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.

1. FACILITY

2. Address t?(O 9o (A) ~~rJ S~ Borough Zip IobO}

12 V2 S S1 3. Block ! 3J 4. Lot t k3 5. Type of Facility_ Yp. ~~~ G-6 ~_ 6. Name of Building

It. BUILDING OWNER

7. Name _RQ2- 1 D t-LC- • • 8. Contact Person

9. Tei. 4 Ca ~D- 5'7 0C Fax# elrl3~~~ 5 t ({ Zip !__o 0 10. Address (a `[ c, City l~ ' State ~ _

III. GENERAL CONTRACTOR

11. Name Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR T /~~ 12. Name et W~ — 13. Contact Person _7 ~ 'y' e2 &,B P11 14. Federal Employer ID. #J4-._..._._._._._._._._._. ..._..._..._..._._.'15. Tel. # — 7/3(00 Fax # 5I — ?W/' 3"O 5 d 16. Address —3o fb &&E A/e City KJ thUI State /J'{ Zip I (7 c'?

V. THIRD PARTY AIR MONITOR r 17. Named~$`J pp A PkhtZF2 -: 1G t S h pC 18. Contact Person t% oC krJ .

19. Federal Employer ID. # 20. Tel. # ' 1P - 9as- OOj Z Fax # 2Ja ^ 22a - 06 ,3 0 , rr oo 21. Address ,~~ g ~kS( k -J S'- E ( City tk_ 77IS State _ Zip

22. Sample Analysis Laboratory SC f{ 1 4' - r~ kfj t e4 ~lC- 23. NYS DOH EIAP # _-d-

Vi. PROJECT INFORMATION 24,Starting date for this portion of work 1 \ Projected completion date I1 3'D

Asbestos work schedule 0 Monday ❑ Tuesday ❑ Wednesday ❑ Thursday 0 Friday ❑ Saturday_❑Sunday

Shift from: ❑ am ❑ pm to ❑ am ❑ pm

If other, specify i N Ffy Access to kzspecf the peruses must be provided during the work schedule indicated in this kern. 0 ~~

25. Total amount of asbestos-containing material to be abated during this work

_. Square Feet, and/or Linear Feet 8 ACP 7 2/2001

'.1 -- ...... . ~".'::i':;f.•Y { -`Vim_ "O;trAl

NYC-WTC 000112874