NYC 9/11 Public Portal Document
5.— .NYC DEPARTMENT OF ENVIrL LMENTAL P , ECTION FOR OFFICIAL USE ONLY
%~' a:~ Asbestos Control Program • Fee (if any) S
ONLY Dip ' I 59-17 Junction Boulevard, 81^ Floor, Corona, NY 11368-5107
TYPEWRITTEN
FORMS WILL BE
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ASBESTOS PROJECT AMENDMENT FORM yy
ACCEPTED •••••r.•••./o.o FOR FORM ACP 7 Information Only: ❑ Yes ❑ No
A modification Is valid only If it is received by the NYCDEP prior to the previously filed date of
~ completion, except for start date changes that must be received by the original start date.
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A P7 TRU/BN# Facility Address __wI Borough • I Zip
Date ACP7 was filed L 0 — Variance # (If any)
Was this ACP7 amended before? ❑ Yes No If yes, specify date
Original Start Date --"Tii4 'c2 Original Completion Date 7 In a. from ACP 7, #24.
PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified no more than twice.
Only the building owner may amend items IV and V.
IV. ASBESTOS ABATEMENT CONTRACTOR The original applicant or building owner may amend all other items.
12. Name c1 C~ a 1 2JD ~.. 13. Contact Person _T~ i>V ^ I CAg ç-
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14. Federal Employer ID. {_. _P 11 _ 15. Tel. #{J~~
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16. Address 3 C 1~ $ws,ns ~,1 uE city WA-.J r P4 H States l •'~ Zip fl 3
V. THIRD PARTY AIR MONITOR
17. Name LEN ?M:Z_r. c.NXt /NE~ILI~.~} 1'c. 18. Contact Person •I 1 C. I"P►'E- N
19. Federal Employer ID. # 20. Tel. ' 3) 9 ZZ " 0 D 7 7 Fax # Y~ CJ — 0G
21. Address • CG • L City N Stat I._ Zip t OO1 :1"
22. Sample Analysis Laboratory I t.tJ tj ' C. AAi o QIts aC3. NYS DOH ELAP #_U
VI. PROJECT INFORMATION
24. Starting date for this portion of work li 1
OYProjected completion date t ~
❑ Project Cancelled
0 Project Postponed
Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday
Shift from: ❑ am ❑ pm to ❑ am ❑ pm If other, specify
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25. Additional asbestos-containing material to be disturbed during this work ~a Square- Feet, and/or lYLQinear Feet
Reduction in the amount of ACM to be disturbed during this work Square Feet, andAdG 1 4 l2 2r Feet
29. Abatement Procedure for Additional Material (Check all appropriate boxes)
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❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application
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Other Changes
30. Locations of abatement modified by above 1Z5-14 .- t
(For each floor list ACM quantity and ty )
31/32. Name of Applicant / Owner ''e- Tel. # 1 L __
I ►~✓ 0
Name of Company (If any) L~ C-1d__- 9 Fax #
Address City State Zip
I hereby declare that the Information provided herein is true and complete.
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E F ignature of Applicant /Owner Date-
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,vc' ACP8
Sys 5 2=1
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NYC-WTC 000122898
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