NYC 9/11 Public Portal Document
'NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8"' Floor, Corona, NY 11368-5107 .--•-----
auwng Dept. or TRU No
FOROFFICN.USEONIY
-
EWRITTEN ~°a ASBESTOS PROJECT NOTIFICATION I
tAirm r~
S WILL BE ..... (ASBESTOS INSPECTION REPORT) 1
ACCEPTED .wn.er~.:crtecr. (see fee )
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
2.1 S PEA tz.L 51 2 e~T Borough MAN _ Zip it)03t3
2. Address
3. Block 68 4. Lot 4
AKA
5. Type of Facility 6. Name of Building
11. BUILDING OWNER
7. Name ~ 8. Contact Person
9. Tel. # Fax #
10. Address _ City State ______ Zip
Ill. GENERAL CONTRACTOR
11. Name_ ._._---_— Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name ~wArvt t N kt1 R 7 BAu 4 _Sc:a C c INC 13. Contact Person s t L P T
14. Federal Employer ID. #J------------ P11 15. Tel. # ~t f,~ a3i - ~gcP Fax#_o~i? 2o9N t e5ofi____
flv EN `' c _ City _ LN — State NY— Zip 112 --
16. Address 12 QI
V. THIRD PARTY AIR MONITOR
17. Name CLAtZiL tJ $ Pao zr`re. ~ ~,t N aas 18. Contact Person ~OtAN
19. Federal Employer ID. # P11_._._._._._., — 20. Tel # C2 t2) _922-oO ii — Fax # _ C2t2) 022-
21. Address 2 2 £s EAST 4S Tr•t ET City !o£. e- _ State !3Y _ Zip _ IZUi'C
22. Sample Analysis Laboratory, 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
24. Starting date for this portion of work C 9 {} to JO 7- _ Projected completion date J.2' 1_02
Asbestos work schedule ® Monday ® Tuesday ® Wednesday 0 Thursday 0 Friday 0 Saturda, ® Sunday
Shift from: -- ® am ❑ pm to ❑ am I pm
If other,
specify __ ____ _ FECEJVED t
Access to inspect the premises must be provided during the work schedule indicated in this item.
SEP 6 '?
z
25. Total amount of asbestos-containing material to be abated during this work
9960 0 Linear Feet
Square Feet, and/or
ACP
2=
NYC-WTC 000115190
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