Invoice from Fiber Control Inc for facade remediation, 118 Chambers

NYC 9/11 Public Portal Document S

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ASBESTOS INSPECTION REPORT (cont ae

26. Asbestos Hauler a. NYS DEC Permit 0 Tel. c ' 7Z ? Disposal Site(s) UI e2 N67/1-g-94 424 5 \?*([e( f 27. This asbestos abatement is part of a (Item a through a requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) 0 Renovation/Alteration e) ❑ Fireproofing Replacement f) ❑ Other (Describe)

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application '`' - 4n 1 Ar`ETtrlAlt2 AC ARATCUCMT /J / 7 Z. DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.p entire, east wing. room 9. (e.p. Pip. 4 S19in . cadsg, phantm SQUARE LINEAR (e.p rtrtnrg cable, installing fire sprinklers. FEET • FEET rentovl and a atc,) biller room, Cobb . etc) ducts. stoi e tanks, . etc.

31. r 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 taws and regulations applicable to asbestos related work.

SLr ~ Ll at tit /v~ c i)h,71Z!}r / Pnnt N r itor Name AS stoe Contractor Pnnt Nari of App ant (If otter than Owner)

t Signature nature Signature

Date Oete Date

32. 1 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 asbestos project I hereby declare that I have authorized the filing of ibis notification for the work specified herein. 1 /1 J —4 Pnnt Name of Owner Signature Wte

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 ptecemeal fashion. aryoot

NYC-WTC 000121924