NYC 9/11 Public Portal Document
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NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY
~~^,~ 'Asbestos Control Program Fee (if any) $
DU P +i 59-17 Junction Boulevard, 8" Floor, Corona, NY 11368-5107
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Z. Amendment 27 T t
F•O WILL1LL8E
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=~" ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes ❑ No
A OPTED ~ ••.nr ia•/~.o FOR FORM ACP 7
A modification is valid only if it is received by the NYCDEP prior to the previously filed date of
completion, except for start date changes that must be received by the original start date.
ACP7 TRUBN# 1 5; g 7Mnb) Facility Address 1' 3 57 w £,'3 Sr I Zip /1)& 7
Date ACP7 was filed / 0 ~- Variance # (If any) /~ s
Was this ACP7 amended before? ❑ Yes W No If yes, specify date /7' c
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Original Start Date Original Completion Date
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PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notifi e y be "' pmore .
Only the b it ertfi end ite I~ nd V.
The on9inaf 1J n$buiIY19 ocier rnVmend all other items.
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name \ 13. Conta erson _`~~f`~ C T'
14. Federal Employer ID. #._._._._._._._._._ _ P ~ ~ 15. Tel. # , I 3 ~ ax # ` )
16. Address 2c> I re,S -~-≤-- City W-Pr- i1'`P - (* State -' ZiP _ _
V. THIRD PARTY AIR MONITOR
17. Name Q f -2$ l PL 18. Contact Person jCLckQl kç
19. Federal Employer ID. # 20. Tel. # - O 7 1 Fax# N 1)!)
-
21. Address ?- City N` y State N ' \Zip 1 d 31r-
22. Sample Analysis Laboratory iJ' C_ '_k is ' C-23. NYS DOH ELAP # l\ ~°
VI. PROJECT INFORMATION ❑ Project Cancelled
24. Starting date for this portion of work i [C) )— Projected completion date ' 3~ oy ❑ Project Postponed
Asbestos work schedule 0 Monday 0 Tuesday ❑ Wednesday 0 Thursday ❑ Friday ❑ Saturday ❑ Sunday
Shift from: ❑ am 0 pm to ❑ am ❑ pm If other, specify
25. Additional asbestos-containing material to be disturbed during this work Square Feet, and/or Linear Feet
___ ,^,
Reduction in the amount of ACM to be disturbed during this work -k )0 D Square Feet, and/or Linear Feet
29. Abatement Procedure for Additional Material (Check all appropriate boxes)
0 Full Containment 0 Glovebag ❑ Tent ❑ DEP Variance Application
Other Changes
30. Locations of abatement modified by above b 1' (~ o
v`r^^~`' ~L~Q~. v~Q..~.~5 ci_ Q: /-
(For each floor list ACM quantity and type)
31/32. Name of Applicant/Owner / T -T 1~ /i/i7P/t Tel. #i -S r- /
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Name cf Company (If any) Fax #
Address City State Zip
I hereby declare that the information prr.•viiead herein is true and complete
_____________
Sign ure of Applicant /Owner
I4 Date
ACP 8
o Rpi M ENMMRrOV M
•b_r 4TnY. L EWMENtNT 201
*rfS TROT
NYC-WTC 000113293
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