Invoice for facade cleaning at 15 Park Row, Feb 2003

NYC 9111 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) 26. Asbestos Hauler CO 0 NYS DEC Permit _C) Tel. 9 ' —~ 7 Z ^ c 7 Disposal Sites) OI e2N ~'} e5 *( fl (

27. This asbestos abatement Is part of a (Item a through a requires filing of this form with NYC Department of Buildings) . ; a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinider Replacement • d) 0 Renovation/Alteration e) ❑ Fireproofing Replacement n ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ~t ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ❑ Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application 7 9 Q 4 4 ` SM LOCATIONS OF ARATIMMcMT . DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g entire, asst wino. room s. (e.g. Poe bpyfiy. ca . pier n SQUARE LaIEAR (e.g. nv*ç cable. Installing fire boner room . ete ducts. tanks. .etc. FEET • FEET and b~ ~

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.

_ - ScrNE Print itor M / &Y ' Name/I C7 Contractor i4 , o ( hcd Print Na. of App G nt (If other than Owner)

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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 thorn or who is completely independent of all parties involved in the asbestos project. I hereby declare that I have authorized the ing f this notificati or the specified herein. #

- r Pont Name or

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

[IlAny modification of information provided on this form must be reported immediately In writing directly to the NYC DEP ACP. requirements of the Asbestos Control Program Rules may not be lawfully avoided or

NYC-WTC 000115652