Invoice for roof cleaning, 2 South End Ave, Mar 2003

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) _ 26. Asbestos Hauler -~ I"' NYS DEC Permit 0 Tel. 2 ? ~ 7

Disposal Sites) es 1fri( 4t4F/(( S

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 a) ❑ Sprinkler Replacement. d) ❑ RenovatwNAlteratton e)❑ Fireproofln9 Replacement 1) ❑ Other )

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) .•= = ❑ Full Containment ❑ Giovebag Cl Tent ❑ DEP Variance Application sn LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s)- OF FLOOR CONTAINING ACM PERFORMED (e.g erdlre. east wing. room a. Pipe lapping. clang. p1sntn (e.g eum+ino cable. installing fre spe et _______ Sour room. lobW. etc. ducts. storm. tenks, dsddm, etc.) FEE? FEET ri4 mp ' biers etc.

3t :-1 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. ,,-

Cantraeoor rk Na . of App nt (if other Yon Owner}

l` Prxn it If Name

r* L22J4 Z Y 4 .

Date oZ Oat. Date

32 I understand that as the owner of a building where asbestos abatement activity occurs. I am responsible for the perfonnanceof S Ole >3isbesio's abatement activities In accordance with the Asbestos Control Program Rules. (have contracted the third party air monitor who'll completely Independent of all parties Involved In the asbestos project. I hereby declare that I have authorized the of.this notifica ' the specified herein.

Print Name of

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. --. - 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 through the performance of work In incremental or piecemeal fashion. air aloe+

NYC-WTC 000117807