Invoice for roof work, 121 Fulton Street, July 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) ' tESf L NY NYS DEC Permit # w -462 Tel,# C'Il8') X22- 226 3 26. Asbestos Hauler BOY 399 Sco fSDAtE .& I T2s4

C Disposal Site(s) OWE t?4Q6G: CAuo Ftu PO

Department of Buildings) 27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration a) ❑ Demolition e) ❑ Fireproofing Replacement Q ❑ Other (Describe) — —

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Enclosure 0 Encapsulation ❑ Repair J Clean up ❑ Removal

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

.In rlr •nwrrllr►Ir JU. LVI.A I IV"Q yr ? D/11 uvl Gil I

AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING DESCRIBE SECTION CONTAINING ACM PERFORMED Floor(s) ( OF FLOOR SQUARE LINEAR (e.g. running cable, installing rire sprinklers, e.g entire, east wing room p, pipe lagging, ceiling, (e.g. Pi n9 Pplenum FEET ' FEET removi and re aci boilers,p etc.) boiler room, lobb , etc ducts, st a tanks. decki . etc.

FAcs_ potzt'tt +Au°ADC (s?) 2080 00 II

knowledge. I am familiar with Federal, 31. I hereby declare that the information provided herein is true and complete to the best of my State and NYC laws and regulations applicable to asbestos related work.

t1JAttr:EN ~Z~ Print Name of Air Monitor IttJtSw B. Prim ame of Asbestos ntraclor Print Name of Applicant (If other than Owner)

Signature Signature Signature r _d i_' Date Date Date

am responsible for the performance of I understand that as the owner of a building where asbestos abatement activity occurs. I 32. Asbestos Control Program Rules. I have contracted the third party air the asbestos abatement activities in accordance with the that I have authorized the monitor who is completely independent of all parties involved in the asbestos project. I hereby declare filing of this notification for the work specified herein. DE's _6I8/ 02 Signature Date Print Name of Owner AVAILABLE AT THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE writin direct) to the NYC DEP ACP. An modification of information rovided on this form must be re rted immediate) in or lessened of the Asbestos Control Program Rules may not be lawfully avoided ugh the performance of work in incremental or piecemeal fashion. ,,)Poro,

NYC-WTC 000119505