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

NYC 9/11 Public Portal Document LA -""""" ASBESTOS INSPECTION REPORT (continued) = 26. Asbestos Hauler Cogpp0 : wea nae Pom CTO? on R0m-27F-BSC7 pispout sin Dodi herw fHlechenies , flley HI = ae 27. This asbestos abatement fs part of a (Item a through e requires filing of this form with NYC Department of Butidings) a) Ci demotion . t) C1 BotterReplacement - ) LJ Sprinkler Replacement - o) CI Renovation/Atteration _-@C Fireproofing Replacement 4 [1 other (Describe) 28. TYPE OF ABATEMENT (Check all appropriate boxes) ~~ _ ef _ OF Removal DO Enctosure EC] Encapsulation CT repair 1 ciean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) - 4 # {J Fun Containment [1 Glovebag [1 tent [1 Dep Variance Application ee 30. LOCATIONS OF ABATEMENT ; DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM | DESCRIPTION OF WORK BEING Floor(s)- OF FLOOR CONTAINING ACM PERFORMED ; (¢.g. entire, cast wing, room #, (e.g. Pipe tagging, calling, plenum | SQUARE {0.g. running cable, instalting fire sprinklers, f boiier room etc) . ots, tan te) | FEET fEET femoving and replacing bollers, ete.) f oe er 18,850 : a ee e i. ae. a a a 3 ; & e k . > F t 31.>1 hereby declare that the information provided herein ts true and complete to the best of my knowledge. | am familiar with Federal, State and NYC taws and regulations applicable to asbestos related work. Po : Bocue CXGunance| Pfr Gorn | hothal sip. moet ; yuu 3 ora a4 Name Ai Contractor Pant Name of Appicant (#f other than Owner} i ete : . ; Signsure - J : Signature a, OO\OZ-08. 6-3-0 - G+ 3-02 ar 7 Date ___Oate Date 32. 1 understand that as the owner of @ building where asbestos abatement activity occurs, ! am responsible for the performance of _ the asbéstes ‘abatement activities in accordance with the Asbestos Contro! Program Rutes. { have contracted the third party air ‘monitor who'ls completely independent of all parties involved In the asbestos project. | hereby declare that | have authorized the % filing of this notifica the specified herein. | ni dhaces se he o ol ag{0% A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. —-=- —{ 77 Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. a The requirements of the Asbestos Control Program Rules may not be lawfully avoided or jessened through the performance of work in Incremental or piecemeal fashion. ‘ ear 4 az001 NYC-WTC_000117993