Invoice for roof cleanup at 47 Broadway, June 2002

NYC 9/11 Public Portal Document y

ASBESTOS INSPECTION REPORT (continued) 26. Asbestos Hauler Asbestos Trans. Co. NYS DEC Permit # 1A-371 TEL,#_(631) 924-5050 DlsposalSlte(s)Imperial/P.O. Box 47, 11 Boggs Rd.PA; Southern Alleghenies/Rd 3 27. This asbestos abatement is part of a (Item a through .-..~.. .11 V, Vwd.d.c1 V.l.CW . ;.PA e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) 0 Boiler Replacement c) ❑ Sprinkler Replacement d) 0 RenovationlAlteration e) ❑ Fireproofing Replacement t) 0 Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair 0 Clean up 29. ABATEMENT PROCEDURE (Check all appropriate. boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application 30. LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM (e.g. entire, east wing. room 0. SQUARE PERFORMED (a9• Pipe tagging, ceiling. Plenum UNEAR (e.g. running Cable fire sprinklers, baler room ,etc) ducts tanks. decking. etc FEET FEET removing and replacing boilers. etc 47 Broadway Roof Item NO. 1 345 Roof Item No. 4 2,500 Walls Item No. 7 2,300 . Facad Item No. 7 2,100 23 Trinity Roof Item No. 1 460 Roof Item No. •4 2,50 Walls Item No. 7 3,45 Facad Item No. 7 1,57

31. 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.

arren & Panzer Trio bestos Removal NYC Print Name of Air Monitor P' am of Asbes orator Print Name of Applicant (if other than Owner)

r.~5v ^ r // l I S Signature Signature

Date Date Date

32. I understand that as the owner of a building where asbestos abatement activity occurs. I am responsible for the performance of the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have contracted the third party air monitor who is completely independent of all parties involved in the asbestos project. I hereby declare filing of this notification for the work specified herein. that I have authorized the

47 Realppp Corp C/o NYC Print Name of Owner Signature Date 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 direct to the NYC DEP ACP. Asbestos Control Program Rules may not or ACPT Le performance of work in incremental or o 20Mf

NYC-WTC 000118005