Invoice for roof remediation work, 25 Beekman Street, July 2002

NYC 9/11 Public Portal Document

25 tEl MAiJ El —

r !r INSPECTION REPORT (continued)

. 26. Asbestos Hauler IESI,NY - NYS DEC Permit # NJ-462 TeI.# (718) 522-2263 Disposal Sf ) BluePidge Landfill PO Box 399 Scotsdale, Pa 17254

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) ❑ Boiler Replacement C) 0 Sprinkler Replacement d) ❑ Renovatlon/Atteratlon e) ❑ Fireproofing Replacement 0 El Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application 3n I[XATIfl1J n=eaAYCUCUT Oren ♦AA---._ . ~_......rrc DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM (e.g. entire, east wing, room I, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR PERFORMED (e.g. running cable, installing fire sprinklers, room, orn, lobby,etc ducts, storage tanks. dedci ,etc.. FEET FEET removing and M boilers. etc.) Woe ROOF surZFP.cE 5950

Mc Si tt CA -SE 9O0 4 PAlzo.t T U.1 LL 960

PArzAer LED- 240

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.

Print Name of Air Monitor Prin Nam beest Contractor Print Name of Applicant (If other than Owner)

-- ----- ---- -- -------- ignature Sig alure Signature n

Date C̀ - R te. - --- ~— — -- Da e 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 asb stos project. I hereby declare that I have authorized the filing of this notification for the work specified herein.

Print Name of owner -- Signature sc _ 06 104102 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 directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be Lawfully avoided or lessened through the performance of work in incremental or piecemeal fashion ACP2 2noot

NYC-WTC 000118732