Invoice for roof cleanup, 106 Liberty Street, Aug 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) TEL.# 631 924-5050 26. Asbestos Haulerfr t ortation Co. NYS DEC Permit # 1A-371

Disposal Site(s)Imperial/POB 47, 11 Boggs Rd., PA: Southern Alleghenies/Rd 3 Valleyview Dr., PA 27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement f) 0 Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ❑ Cleanup

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment 0 Glovebag ❑ Tent ❑ DEP Variance Application /, O5r0.y -/O w 30. LOCATIONS OF ABATEMENT /V Lam► DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. enure, east wing, room 0, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing rire sprinklers. boiler room, lobby, etc) ducts, storage tanks, decking. etc.) FEET FEET removing and replacing boilers. etc.)

Roof Item No. 2 Asphalt Roof 3600 F4cck Facades No so & $O,0

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.

Warren & Panzer rio Asbestos Rmvl.Crp NYC Pint Name of Air Monitor Pri a f s Contractor Print Name of Applicant (It other than Owner)

0i 'L Signature . Signature . Signature

/ 6. /2 Date ale ________________ Date

32. I understand that as the owner of a building where asbestos abateme tivi occurs, I am responsible for the performance of the asbestos abatement activities in accordance with the As stns ontr P ve contracted the third party air monitor who is completely independent of all parties involy dAn e asb o prograLiFbrebly eclare that I have jthoriz,d the filing of this notification for the work specified herein. c/o NYC DZ Print Name of Owner Signature Oat

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

Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened ACP7 through the performance of work in incremental o(piecemeal fashion. X 001

NYC-WTC 000116629