NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMEN ROTECTION
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Asbestos Control Program
59-17 Junction Boulevard, 8' Floor. Corona, NY 11368-5107
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DP)) ``,l ASBESTOS PROJECT NOTIFICATION
Buading Dept. Or
FOR OFFIGAL USE ONLY
7F RMS WILL BE`' 7rrrna
—_ (ASBESTOS INSPECTION REPORT)
ACCEPTED (---•.ra.c.• ~.r 1.
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.
1. FACILITY
50 Broad Street Borougtl"anhattan Zip10004
2. Address
24 36
AKA 3. Block 4. Lot
5. Type of Facility 6. Name of Building
II. BUILDING OWNER
Inc. /50 New Str., Inc
. 7. Name 50 Broad Str., Contact Person
9.Tel.# 212-425-1058 Fax #
10. Address City State Zip
Ill. GENERAL CONTRACTOR
11 Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12.Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan
14. Federal Employer ID. # i_._._._._._._.. ~._._._._._._. 15. Tel. # 71 8-961-4100 Fax # 71 8-961-4103
16.Address 14-20 129th Street citvCollege Point State NY Zip 11356
V. TH R^ f'^ t TY 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 New York State NY Zip 10017
22. Sample Analysis Laboratory Warren & Panzer Engineers 23, NYS DOH ELAP # 1 1 251
VI. PROJECT INFORMATION
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24. Starting date for this portion of work ` Z Projected completion date I ~" 1foL
Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday 0 Thursday ❑ Friday ❑ Saturday 0 Sunday
Shift from: _______Dam ❑pm to Dam ❑pm •
If other.
specify
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Access to inspect the premises must be provided during the work schedule indicated in this item.
2 20 !hEj
25. Total amount of asbestos-containing material to be abated during this work
_ BESTOSII.E~- ~,
PROGRAM
55 , 620 Square Feet, and/or Linear Feet Tat G
AGP7
7 2/2001
NYC-WTC 000118508
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