Asbestos inspection report application, 41 Broad Street, 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler ASBESTOS TRANS. CO. NYS DEC Permit # 1A-371_____-- Tel.# (631) 924-5050__ Disposal Site(s) IMPERIAL- P.O. 47, 11 BOGGS RD., PA. / SOUTHERN ALLEGHANIES - VALLEYVIEW DR., PA.

27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Baler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement f) ❑ Other (Describe) ___ --------------- 28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure ❑ Encapsulation 0 Repair 0 Cleanup 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment 0 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 PERFORMED (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, boiler room lobb etc) ducts storage tanks dedcin etc.) FEET FEET removing and replaang boilers, etc.) 1-10 FL. FACADE WINDOWS, LEDGES 3,380 ITEM #8 ROOF MAIN & SETBACK ASPHALT & DUNNAGE 9,677 ITEM #3

31. I 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.

WARREN & PANZER ENG., P.C. TRIO ASBESTOS REMOVAL STEVEN PARMIGIANI Print Name of Air Monitor Print Name of Asbestos Contractor Print Name of Applica t (If other than Owner)

Signature i nature lure

it o v a- ate 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 mpnitor who is completely independent of all parties involved in the asbestos project. I hereby declare that I have authorized the filing of th/s-notification for the work specified herein.

Print,Name of Owner Signature Da

A STAMPEbCOPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

Any modificati8n of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. of the Asbestos Control Program Rules may not be lawfully avoided or lessened ugh the performance of work in incremental or piecemeal fashion. ACP7 212001

NYC-WTC 000118566