Asbestos inspection report form, 49 Broadway, July 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) 26. Asbestos Hauler _147r- NYS DEC Permit # Disposal Site(s) 27• This asbestos abatement is part of a (Item a through e requires filing of this a) 0 Demolition b) ❑ Boiler Replacement form with NYC Department of Buildings) e) 0 Fireproofing Replacement ~) ❑ Speer t) ❑Other (Describe) Replacement d) 0 RenOvatwNAlteration 28. TYPE OF ABATEMENT (Check all appropriate ❑ Removal boxes) ❑Enclosure 0 Encapsulation 0 Repair ❑ Clean up 29. ABATEMENT PROCEDURE (Check all ❑ Full Containment appropriate boxes) ❑ Giovebag ❑ Tent 0 DEP Variance Application a "Kit3t StCTION OF FLOOR AFFECTED SURFACES COUNT OF ACM 71~ DESCRIPTIONQO QO BEING OF WORK Z- (e.( entire. east wing. room . CONTAINING ACM tone► t etc (e g. Pipe to d > t~enum st7t1ARE PERFORMED etc. FEET FEET oof Item No. Z f~ rem a e' bo s etce`S• ails Item No. '7 3405

I hereby declare that the State and NYC laws and information provided herein is true and complete to regulations applicable to asbestos related work. the best of my knowledge, I am familiar with Federal,

Trio Asbec Air Remo'ral NYC Print Name Of AWScant ttf other than O" d

6 Signatuje

I understand that as Date the the asbestos abatement owner of a building where asbestos abatement activities in accordance with the Asbestos activity occurs, monitor who is completely Contr Program responsible for Performance of filing of this notification independent of all for the work specified patties involved/'✓~ ' t b s I hereby contracted t etlte third air herein. declare that I have authorized Ahl Midtown Pror~ert Print Name of owner c/o NYC (./ Signature A STAMPED COPY OF bat THIS FORM INCLUDING AMENDMENTS MUST BE AnY modification of informafinn .. . AVAILABLE AT THE WORK SITE.

ACP7 2/2001

NYC-WTC 000118067