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← Document results/DEP Box 45/33 PARK PLACE 1001410, 126/2
Document / 6 pages

Asbestos project notification form, DEP, undated

Machine-extracted title · confidence 90%

Form header for an Asbestos Project Notification regarding inspection at a location.

NYC-WTC_000115929–000115934

Folder label: “33 PARK PLACE 1001410, 126/2

Page image
Scanned page image, NYC-WTC_000115929
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

V ' o:n

I AM ^\\ t { NY DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, BS' Floor, Corona, NY 11368-5107 iq iqwo I Bing Dom. orTRU ONLY FOR oFmcm usF-

tVRtTTEN ~~ : /o~ ASBESTOS PROJECT NOTIFICATION FORMS (ASBESTOS INSPECTION REPORT) 1 $1200 ACCEP w •o' .gov ee.!!1 (See fee schedule)

When submJDg.. at the iYC Department of Buildings, the original form and three (3) copies original signatu t ty s u red. Submitf2l at the NYCDEP requires one copy of the form with abatement tr must be submitted to the NY EP not less than one week in advance of the start of

I. FACILITY Borough Manhattan Zip 10007 2. Address 110 Church Street 3. Block 126 4. Lot 2 AKA

5. Type of Facility Vacant Commercial Bldg. 6. Name of Building

11. BUILDING OWNER Riegler Worldwide Holdings Inc8. Contact Person Michael 7. Name Lions Head 110 Development LLC do

9. Tel. # (212) 948-6200 Fax # (212) 486-4665 City New York State NY Zip 10155 10. Address 150 East 58th Street

Ill. GENERAL CONTRACTOR Tel.# 11. Name

IV. ASBESTOS ABATEMENT CONTRACTOR Robert Ryan Environmental Corp _._._._._._ _ 13. Contact Person 12. Name Pinnacle P11 (718) 397-9292 Fax # (718) 397-1472 14. Federal Employer ID. #;._._._._._._._._._._._._._._._._._._._.- 15. Tel. # City Maspeth State NY Zip 11378 16. Address 64-54 Maurice Avenue

V. THIRD PARTY AIR MONITOR Consulting Assoc 18. Contact Person George Russell 17. Name Environmental Monitoring & ik,_._._._._._._._._.P I I 20. Tei. # (732) 249-3005 Fax # _(732) 249-3384 19. Federal Employer ID. City Sommerville State NJ Zip 08876 21. Address PO Box 872 23. NYS DOH ELAP # ii &Q1___ 22. Sample Analysis Laboratory...P&&

VI. PROJECT INFORMATION 11/27/01 Projected completion date . 1/31/02 _ 24. Starting date for this portion of work -

21 Monday 0 Tuesday El Wednesday [D Thursday 0 Friday D Saturday D Sunday Asbestos work schedule 10 11 Dam Dpm to 5.30 _ Dam ©pm o~ Shift from: 7.00 4 If other, specify .---.---- —` RECEIrtU tt, NOV V 2 9 001 Access to inspect the premises must be provided during the work schedule indicated in this item. 2

during this work 25. Total amount of asbestos-containing material to be abated ~~; r1CGRAM-'

622.702 Square Feet, and/or 0 Linear Feet ACP 7 7th 212001

NYC-WTC 000115929

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NYC-WTC_000115929Source: NYC Law Department, mirrored locally

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