TOTAL FEET: 1500 0
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Basis of Inspection:
ASBESTOS INSPECTION REPORT
TRU0954MN02
ONLY rYPEWRMrffN FEE EXEMPT: Yes
APPUCAT1ONs KILL 6E NOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED
ACCEPTED 1. $0.00
TO NYC DEP NOT LESS THAN ONE WEEK IN ADVANCE
OF START OF THE WORK (ABATEMENT ACTIVITIES) ❑ Variance
START DATE: 6/29/02 PROJ. COMPLETION DATE: 8/31/02
1. FACILITY
ADDRESS: 114 CHAMBERS STREET BORO: MANHATTAN ZIP: 10007
TYPE OFFACILITY: BLOCK: 136 LOT: 25 —
II. BUILDING OWNER
NAME: SI JEI MEI INC Contact Jprince ma I
TEL. #: (212) 267.1184
ADDRESS: 61 bowery street CITY: fly STATE: ny ZIP: 10013
IV. ASBESTOS ABATEMENT CONTRACTOR
NAME: FIBER CONTROL INC.
TEL. #: (516) 781.3000
FEDERAL EMPLOYER IDENTIFICATION #:
P11
ADDRESS: 3010 BURNS AVE CITY WANTAGH STATE: NY ZIP: 11793
VI. LABORATORY FOR SAMPLE ANALYSIS
NAME: SCIENTIFIC LABORATORIES INC • NEW YORK CI
NYS ELAP #: 11480
-------------
ASBESTOS WORK SCHEDULE L DAY Li EVENING L-_'' NIGHT CJ WEEKENDS ❑ WEEKDAYS
INSPECTOR NAME: . Q SQUAD #: BADGE #:
DATE OF INSPECTION: / 2 /O.TIME 0 INSPECTION: From: 5O AM I PM
Contact at site: prince ma To: 1 "0 AM _ J PM
Inspection disclosed that the following sections were complied with: (Check all that apply)
1.51 Notifications, Reports Pla 1.71 • Air Sampling and Monitorin f - 1 1.91 • Worker Protection
Li
1.101 •Materials and Equipment 1 116 - Work Place Preparation 1.117 •Worker Decontamination System
1.118 • Waste Decontamination System
L._ j 1 126 - Engineering Controls L 1 127 Entry/Exit Procedures
1.129 • Maintenance of Barriers L 1.138 • Encapsulation r 1.139 -Enclosure
1.140 Glovebag 1.141 •Tent C 1.137 • ACM Disturbance, RemoveL, Handling
1.146 • Preliminary Clean-uP ~~ 1.147 •Final Clean up i
Project not started
Inspection
revealed all ACM to be intact. New start date: / /
Project ongoing expected completion date: / /
Project completed on or about / / All surfaces, including abated surfaces are free of visible ACM and
epcapsulat I
Follow up necessary on / /
Samples taken. No Yes 1 2 3
4 5 6 Photos taken: Yes No
Additional comments:
-- ----
c-. , iC A~ -
BORO 1 MANHATTAN 2 =BRONX 3 = BROOOKLYN 4 RESULT CODE
QUEENS 5 = STATEN ISLAND
RESULT CODES 1 = VIOLATION ISSUED 2 = NO VIOLATION ISSUED 3 = NO ACCESS i- --- -~- i
SUPERVISO I ITT S
4 = PROJECT NOT STARTED (NO NOV) 5 = PROJECT COMPLETED (NO NOV) i
NYC-WTC 000121860
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NYC-WTC_000121860Source: NYC Law Department, mirrored locally