Permit application for roof work, 205 Pearl Street, Sept 2002

NYC 9/11 Public Portal Document

FOR OFFICIAL USE ONLY yo ccYO t4YC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program Fee (if any) $ ONLY 59-17 Junction Boulevard, 8 Floor, Corona, NY 11368-5107 D.P FORMS t Amendment 22/8 FORMS WILL BE f~ Niaigco ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes 0 No ACCEPTED FOR FORM ACP 7

A modification Is valid only if It is received by the NYCDEP prior to the previously fled date of completion, except for start date changes that must be received by the original start date.

ACP7 TRU/BN# 1g3.t1A4 L Facility Address _20 Borough MAN Zip 1008 8

Date ACP7 was filed o91IC (02. Variance # (If any)

Was this ACP7 amended before? ❑ Yes ® No If yes, specify date

Original Start Date Original Completion Date from ACP 7, #24.

PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified no more than twice. Only the building owner may amend items IV and V. The original applicant or building owner may amend all other Items. IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name 13. Contact Person

14. Federal Employer ID. # __ 15. Tel. # Fax #

16. Address City State Zip

V. THIRD PARTY AIR LL n REcEEtvEg 18. Contact Person - 17. Name SP2s Je Fax # 19. Federal Employer ID.

21. Address City State Zip

22. Sample Analysis Lab 23. NYS DOH ELAP #

VI. PROJECT INFORMATION ❑ Project Cancelled 24. Starting date for this portion of work ` Projected completion date ❑ Project Postponed

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

Shift from: ❑ am 0 pm to 0 am 0 pm If other, specify

25. Additional asbestos-containing material to be disturbed during this work 3100 Square Feet, and/or 0 Linear Feet

Reduction in the amount of ACM to be disturbed during this work Square Feet, and/or Linear Feet

29. Abatement Procedure for Additional Material (Check all appropriate boxes) 0 Full Containment ❑ Glovebag ❑ Tent 0 DEP Variance Application

Other Changes

30. Locations of abatement modified by above (For each floor list ACM quantity and type)

31/32. Name of Applicant! Owner Tel. #

Name of Company (If any) Fax #

Address City State Zip

I i 4e declare that the information provided herein Is true and complete. _ og t9 OZ Signature of Applicant /Owner Date a0 c ACP 8 ~~u se'Ntaot 2/2001

NYC-WTC 000115085