Invoice for facade cleaning at 54 Warren St, July 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION (continued) Q REPORT~ ) UL `~ 2 7Z ~60 26. Asbestos Hauler __ L ,~ NYS DEC Permit CT O2 _ Tel. -- --- ~`lI v Disposal Site(s)

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) 0 Fireproofing Replacement f) ❑ Other (Describe) _— ------------------------

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag 0 Tent ❑ DEP Variance Application

nn ATinuc nr A =n ,'rn.r,n T

DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum FEET FEET removing and replacing boilers, etc.) boiler room, lobby, elc) ducts, storage tanks, decking. etc.)

c) ' I As t ~I~sS

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.

Pint N it itor N L~a : Os~n)' —myfAsb stns Contractor Print Naa of App cant (If other than Owner)

Signature gnature Signature

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 ih4 notification for the work specified — —

Date fl Print Name of ofOwner Signature

THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT NYC DEP ACP. An modification of information rovided on this form must be re orted immediate) in writin direct) to the or lessened The requirements of the Asbestos Control Program Rules may not be lawfully avoided throw h the erformance of work in incremental or iecemeal fashion. ACPr u2ooi

NYC-WTC 000113169