Invoice from Fiber Control Inc for facade remediation, 118 Chambers

NYC 9/11 Public Portal Document

J wrc, NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 5i7 Junction Boulevard. 8ei Floor. Corona. NY 11368-5107 r..vt usding Dept. or TTRU No ONLY , - QA1P :. FOR Ofcic& (, USE OM.V TYP ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) tee sc~wduN) When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.

I. FACILITY h~ ~ _ 2. Address T PVVA € S 1 2 -1 Borough __i`t Zip. t Ot C r

AKA 3. Block 3 6 4. Lot

5. Type of Facility 6. Name of Building It. BUILDING OWNER

7. Name o>L1 P1 . ' B. Contact Person

9. Tel, # Fax #

10. Address t C. 4 -PrYN & 2.S 1 Cif$ State t Zip I~719z7

III. GENERAL CONTRACTOR

11. Name Tel.'

IV. ASBESTOS ABATEMENT CONTRACTOR - 12. Name a~~l~pl.G ~ t ' O l! 13. Contact Person ~~-~

14. Federal Em►y to er Ir#, rII $ I6 — 75-f _3OOO ~_._._._._..._._._._.~Y1S. Tel # _ Fax~# 3 5

16. Address 2O1b ()~ ~ city J n~f State Zip I!,?_ ?

V. THIRD PARTY A1 MONITOR

17. Name _&J 1 kZ E2 r( 6 ta4t Pc 18. Contact Person P%1t t J D(" .

19. Federal Employer ID. # 20. Tel. # a (3 - 9aa - O01 Fax* £13 ~~a -OE 3 0 21. Address 02 IR _E/T_42 f City N 7E72 t.. State Zip oO /1S_i'- i / 22. Sample Analysis Laboratory 1 C-te4-rrF(C-- _____23. ' NYS DOH ELAP # Ir ,

VI. PROJECT INFORMATION , 24_ Starting date for this portion of work _0 Projected completion date 1 _ I Asbestos work schedule ❑ Monday =I Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from: ❑ am ❑ pm to 0 am 0 pm

If other, specify

Access to inspect the promises must be provided during the work schedule indicated in this item.

25. Total amount of asbestos-containing material to be abated during this work

3 (d1-S Square Feet, and/or Linear Feet ACP 2r"

L.C•• ~T .l$4NiR~t IFu

NYC-WTC 000121923