215 PEARL STREET 1001118, 68/4

NYC 9/11 Public Portal Document

FOR OFFICIAL USE ONLY . ,~. gip. NYC DEPARTMENT OF ENVIRONMENTAL PRQTECTION Asbestos Control Program Fee (If any) $ 59-17 Junction Boulevard, 8k' Floor, Corona, NY 11368-5107 ONLY TYPEWRITTEN Amendm " 2" FORMS WILL BE i"___. ~p11O.__.__ ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes ❑ No ACCEPTED www.nys.g ovlden 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 TRU/BN# I 7A" 0Z Facility Address 215 PEAR-L S'T25M' Borough MM.1 Zip (DO38

Date ACP7 was filed o9 t io1OZ 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. # _ (_to 16. Address 15.Tel.#City State Zip

V. THIRD PARTY AIR MONITOR P 17. Name 18. Contact Person

19. Federal Employer ID. # 4 :a t i 20 Fax #

21. Address City State Zip

22. Sample Analysis Laboratory 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 ❑ Friday ❑ Saturday ❑ Sunday

Shift from: ❑ am ❑ pm to ❑ am ❑ pm if other, specify

25. Additional asbestos-containing material to be disturbed during this work 1125 Square Feet, and/or o 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) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ 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 hereby de are that the information provided herein is true and complete. l i6 ioa Signature of Applicant /Owner Date Aye ACP 8 ' 2=1

'V NYC-WTC 000115192