NYC 9/11 Public Portal Document
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NYC DEPARTMENT OF ENVIRONMENTAL PRO'T'ECTION
Vi
Asbestos Control Program
59-17 Junction Boulevard, 8"' Floor. Corona, NY 11368-5107
Buik ! DeP1. RU No
ONLY ®r ~rrP1 FOR OFF.CLIL SE ONLY
TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION
(ASBESTOS INSPECTION REPORT)
Eta
(See lee schedule)
When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities .
I. FACILITY
2. Address 1 06 Liberty Street Borough Manhattan Zip 10006
AKA •.,(_(L Ce-4av54'e¢t' ctksa //2—//4L Tyro; jj _ 3. Block _ 4. Lot
5. Type of Facility__ 6. Name of Building
II. BUILDING OWNER
7. Name II ! (t•G~t ICtLI't c Person
9. Tel. # Fax #
10. Address to fjtl I, j't' £. City >1 C.' State( Zip /0o 3'S— SSV
Ill. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan
14. Federal Employer ID. # ti P11 _ 15 Tel. # 71 8 - 9 61 - 41 0 0 Fax # 71 8-961 - 410 3
16. Address _ 1_4-20 129th Street City College Point State _NY Zi p 11356
V. THIRD PARTY AIR MONITOR
17.Name Warren & Panzer Engineers, P.C. 18 Contact Person Michael Nolan
19. Federal Employer ID. # 20_ Tel. # 212-922-0077 Fax # 2129220630
21.Address228 East 45th Street City New York StateNY Zip 10017
22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 11251
VI. PROJECT INFORMATION
24. Starting date for this portion of work 03 02 Projected completion date S 11f 02
/
Asbestos work p.Jedule on ay OTuesday Wiisday ' hursday ridgy aturda unday
Shift from: _Z m ❑ pm t~ ~am m i a 9
If other,
specify _ REWV O
L e5s
to inspect the premises must be provided during the work schedule indicated in (his item.
1(~Y-I
( _
Lt
AUG
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0 1 2002
25. Total amount of asbestos-containing material to be abated during this work ii
R~lfirir(.
.~.r 00 Square Feet, and/or Linear Feet T G
3 2
g levy ACP 7
~FJ Z 2f2001
NYC-WTC 000116628
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