NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTIO
Asbestos Control Program
59-17 Junction Boulevard, 8°' Floor. Corona. NY 11368-510
Building Dept TRU No
ONLY FOR OFFICIAL USE
TYPEW ASBESTOS PROJECT NOTIFICATION
FORMS (ASBESTOS INSPECTION REPORT) 1
( 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
2. Address' 30 WATER STREET Borough Manhattan __ Zip
AKA 3. Block _ 4. Lot
5. Type of Facility _ 6. Name of Building
II. BUILDING OWNER
7. Name VIP (, 1e- cter, ' i . >, C- . 8. Contact Person ~21/
9. Tel. #C2/2-) 233 _/ 7c"o _ Fax # _
10. Address I! ' e City _~Lg-✓XD~~ State Zip / ôb 3
Ill. GENERAL CONTRACTOR
11. Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name TRIO ASBESTOS REMOVAL CORP_ 13. Contact Person STEVEN PARMIGIANI
14. Federal Employer ID. #L.___. . 15. Tel. # (718) 961-4100 Fax# (718) 961-4103
16. Address 14-20 129TH STREET City COLLEGE POINT State NY Zip 11356
V. THIRD PARTY AIR MONITOR
17. Name WARREN & PANZER ENGINEERS, P.C. 18. Contact Person MIKE NOLAN
19. Federal Employer ID. # _._._._._._._P_ 1.!_._._._._._.~ 20. Tel. # (212) 922-0077 Fax # (212) 922-0630
21. Address 228 EAST 45TH STREET Cit , NEW YORK State NY Zip 10017
22. Sample Analysis Laboratory WARREN $PANZER ENG., P.C. 23. NYS DOH ELAP # 11251
VI. PROJECT INFORMATION
24. Starting date for this portion of work 10 J29LD Projected completion date I / / ô O
Asbestos work schedule 0 Monday El Tuesday El Wednesday ❑✓ Thursday ❑✓ Friday ❑✓ Saturday El Sunday
Shift from: 8:00 ❑ am ❑ pm to 8:00 ❑ am ❑✓ pm
If other, 11
specify
RiCEIVED
Access to inspect the premises must be provided during the work schedule indicated in this item.
OGT 29 2002
25. Total amount of asbestos-containing material to be abated during this work $I ao OF E&m0 ~
n~"tseFs~os
U Square Feet, and/or ___ 4,650 Linear Feet
ACP7
2/2001
NYC-WTC 000113690
OCR can misread numbers and units. Confirm readings against the page image before using them.