NYC 9/11 Public Portal Document
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►—s FOR OFFICIAL U
OpjM~,Y NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program Fee (if any) $
w 59-17 Junction Boulevard, 8" Floor, Corona, NY 11368-5107
ONLY
TYPEWRITTEN Amendment so
..__.....-
FORMS WILL BE "y!~ p0.O ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes ❑ No
ACCEPTED ..www.nyc. 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 TRUBN# $flA/O Facility Address 2 1 Z. PEAR b S TRZ E1 Borough M A Zip t 0O 38
Date ACP7 was filed 091toto Z 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 - --;. - 7 ' 13. Contact Person
14. Federal Employer ID. # •' # Fax #
State Zip
16. Address
f?EctL-p -\ City
V. THIRD PARTY AIR MONITO S E P L' 3 2QO?
17. Name 18. Contact Person
19. Federal Employer ID. # 7 -- 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 0 Tuesday ❑ Wednesday 0 Thursday ❑ Friday 0 Saturday 0 Sunday
Shift from: ❑ am ❑ pm to ❑ am ❑ pm If other, specify
25. Additional asbestos-containing material to be disturbed during this work 1000 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)
❑ Full Containment ❑ Glovebag 0 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 declare that the Information provided herein is true and complete.
gnature of Applicant /Ownerw Date
ACP 8
Sr 2/2001
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NYC-WTC 000115260
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