NYC 9/11 Public Portal Document
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NY DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, BS' Floor, Corona, NY 11368-5107
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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
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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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