Asbestos roof cleanup invoice for multiple sites, June 2002

NYC 9/11 Public Portal Document

Poo4LAf[( 3i y,unouly NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION h,t Asbestos Control Program 59-17 Junction Boulevard, B" Floor. Comm. NY 11368-5107 Build' Dept. or TR No f . FOR OFFICIAL USE ONLY EWRITTEN ASBESTOS PROJECT NOTIFICATION FORMS WIU BE "r"-""'n~ (ASBESTOS INSPECTION REPORT) ACCEPTED +erleer- 1.

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 11 2. Address es—C tt Pi , L~ I_~I✓ ` Borough Zip _ l

AICA --____~~-------- — _ 3. Block —_ 4. Lot

5. Type of Facility_........._—Y— _ — ----- 6. Name of Building II. BUILDING O NER t t` 7. Name $L4 N..'.l 8. Contact Person q ft Z ~~1 L ~j j p 9. Tel. #7i ) t a 7L F.. # _--- p F 10. Address Ol~ LO j~_ CityY C-~~L~-~--- ~ t~ State ---- Z'p - r—O _ ' Z_ Ill. GENERAL CONTRACTOR

11. Name_-- __— _ —_ — ------~ Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name --_ _13. Contact Person 14. Federal Employer ID. # PI 5. Tel. # _J ! p 7~I~ 300 0 — Fax # _ JI -~ ~v( ✓des 16. Address o v i!~_--__--- City J /l7vl `~_-- _ State ti Zip iL22 -

V. THIRD PARTY AIRMONITOR

17. Name ~_G" V~ ~✓L 2$`~ hT(Z c /~ ( r ~ 18. Contact Person t 4{ it s

19. Federal Employer ID. #.-.w PII - as - 00 i 20. Tel. # ~r —~---~~~ Fax # 21. Address L S Ss'~~r1 —/~ City ]L fl ——_ State > _ Zip (OG ( 22. Sample Analysis Laboratory__. j ( ((f (L GA6 r; r-Af rIC- S cr' — 23. NYS DOH ELAP # _ I LA __Y_ VI. PROJECT INFORMATION 24.. Starting date for this portion of work o ~ ~ 2- Projected completion date __I 1 '_

Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from: ❑ am ❑ pm to _--__ ❑ am ❑ pm a 9 f0 If other, specify ------- pp i~t ►11~t ,~ ----------------------------------- 0 ~. Access to inspect the premises must be provided during the work schedule indicated in this item. j Ut t3 5 2002 EPBANHN 25. Total amount of asbestos-containing material to be abated during this work ES!OSr PkOGR;+r, LI -'I_t9— Square Feet, and/or Linear Feet S TP2 u Z ACP 7 g: , L~,1.• 1 ;?^e;' P 2!2001 E> :.;i - ' — ---• ~ Gh.. ~

NYC-WTC 000122089