NYC 9/11 Public Portal Document
Eo qcwTc • NYC DEPARTMENT O EI)MRONMENTAL PROTECTIOr
Asbestos Control Program
w f 59-17 Junction Boulevard, 8tI oor,Corona, NY 11368-5107
ONLY
~+~ FOROFFICInr USE ONLY
ASBESTOS PROJECT NOTIFICATION
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(ASBESTOS INSPECTION REPORT) 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.
1. FACILITY
2. Address 18 0 Broadway Borough Manhattan Zip
AKA 3. Block 65 4. Lot 18
5. Type of Facility 6. Name of Building
11. BUILDING OWNER
7. Name Downtown Realty Operating Corp 8. Contact Person
9. Tel.# Fax#
10. Address Cfty State Zip
III. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannioo
14. Federal Employer ID. #_._._._._._.P.1~._._._._._. 15. Tel. # (718) 531-2900 Fax # (718) 209-1808
16. Address 1248 Ralph Avenue city Brooklyn State NY Zip 11236
THIRD PARTYAIR MONITOR
t. Name "` • 18. Contact Person
19. Federal Employer ID. # P1I _._._._._._. ___ 20. Tel. # (212) 922-0077 F # (212) 922-0630
21. Address 228 East 45th St city New York State NY Zip 10017
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
1 24. Starting date for this portion of work _01 I i'2 62- Projected completion date _0 1. t2.W 2.
Asbestos work schedule 00 Monday I Tuesday ® Wednesday ® Thursday I Friday IS Saturday ® Sunday
Shift from: 8 0" ® am 0 pm to * ❑ am ®'pm
If other,
specify
Access to Inspect the premises must be provided during the work schedule Indicated In this Item.
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25. Total amount of asbestos-containing material to be abated during this work ' r~•3id`26fi'.'
ESTOSit.
1.9309 -1 Square Feet, and/or 0 Linear Feet TRUG
ACP 7
212001
NYC-WTC 000122824
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