Invoice for facade remediation, 109 Reade Street, July 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler LO 0 NYS DEC Permit O C 1 O —272 3&, Tel.

Disposal Site(s) JOU I ek P ~~ pN ~e 5 I 27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) :l a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement f) ❑ Other (Describe) _

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

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

30_ LOCATIONS OF ARATFMFMT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable. installing fire sprinklers, boiler room, lobby. etc) ducts, storage tanks, deckin , etc.) FEET ' FEET removing and replacing boilers. etc.)

+ R7

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.

LLB /4A)1/ )/ ~yl P-mn tor Prin Name/) Asbestos Contractor Print Nam of App nt (If other than Owner)

K cP 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 this notification for the work specified herein.

-' Print Name of Owner Signature Date

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

A Modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. 1., ~.. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the perforrnartce of work in incremental or piecemeal fashion. I AcP>•' .; V2C . )

NYC-WTC 000114645