Asbestos removal invoice, 48 Beaver St, Jun 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT continued spescos Lr(anspor )tati.on 26. Asbestos Hauler Co. NYS DEC Permit tf 1 A— 3 71 TELt,6 31 - 9 2 4 -50 5 0 DisposalSite(s) Imperial/POB 47, 11 Boggs Rd., PA; Southern Alleghenies/Rd 3 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) 0 Demolition b) ❑ Boiler Replacement c) 0 Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement t) ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ❑ Cleanup

29. ABATEMENT PROCEDURE (Check all appropriate. boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

3Q_ LOCATIONS rIF AR.TFMFM r DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM (e.g. entire, east wing, room it, PERFORMED (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. ov running cable, installing fire sprinklers, boiler room, lobby, etc ducts, storage tanks, decking, etc. FEET FEET removing and replacine balers, etc.) Roof Item No., 2 3250

I __

I 1 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 Trio Asbestos Removal NYC Print Name or Air Monitor Print Name of As los Co rad Pri Name f Applicant (If other than Owner)

Signature Signature Signature

t~v Dale 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 t asbestos project. I hereby declare that I have uthorized the filing of this notification for the work specified herein. Time Equities C/o NYC Print Name of Owner Z( n C L Signature I 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 rol Program Rules may not be lawfully avoided or lessened ACP7 throuah the Derform of work in incremental or piecemeal fashion. 2!2001

NYC-WTC 000118938