NYC 9/11 Public Portal Document
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NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8e Floor. Corona, NY 11368-5107 ~Ooy
8u~mnp Dept. or TRU No
FOA OFFIC*AL USE ONLY
TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION
FORMS WILL BE (ASBESTOS INSPECTION REPORT)
ACCEPTED ( ., .yc.ser dap 1. •
(See fee ties
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
47 Broadway/23 Trinity Place Manhattan Zip 10006
2. Address Borough
AKA _ 3. Block 2 0 4. Lot 12
5. Type of Facility 6. Name of Building
II. BUILDING OWNER
7. Name
A7 Ps opp Corp
• 8. Contact Person
9. Tel. # 212-868-9290 Fax#
10. Address City State Zip
Ill. GENERAL CONTRACTOR
11. Name ' r Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris
Horan
14. Federal Employer1D.# P~~ - -' 15. Tel.#718-961-4100 Fax# 718-961-4103
16.Address 14-20 129th Street City College Point State NY Zip11356
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 # 212-922-0630
21. Address 228 East 45th Street City NY State NY Zip 10017
22. Sample Analysis Laboratory 23: NYS DOH ELAP # 11 251
VI. PROJECT INFORMATION
24. Starting date for this portion of work 6/"/t72 Projected completion date d
Asbestos work schedule ❑ Monday ❑ Tuesday 0 Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday
Shift from: ______Dam ❑pm to Dam ❑pm .•." '' ~~ I'
If other, ~.~
specify
2
Access to ins
Inspect the premises must be provided during the work schedule indicated in this item.
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25. Total amount of asbestos-containing material to be abated during this work -3 :;.5!0S•...
P -OGRAA'.
1 5, 230 . Square Feet, and/or Linear Feet
ACP 7
212001
NYC-WTC 000118004
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