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183 BROADWAY 1001074, 63/16

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000122992–000122998
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NYC 9/11 Public Portal Document

X002 w`~'G• .. NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8°' Floor, Corona, NY 11368-5107 ` O8O CIO Bonding dept. er TRU FoROFFICW. USE CMV ASBESTOS PROJECT NOTIFICATION USE L8fQo (ASBESTOS INSPECTION REPORT) TED (see tee schedule) When submitting this form at the NYC Department of Buildings, the original forth 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 ii P /~ 2. Address _I £ -O Borough N ( zip 1C) 0 AKA 3. Block 4. Lot 5. Type of Facility 6. Name of Building H. BUILDING `OWNER i~ t-( St f}e ,~ ~. 7. Name__ h:Ue~z.•t~ t A -, 1~ t~ -t tt ' 8. Contact Person 2. l 2 'tq (O').

9. Tel. P11 Fax # 10. Address _, 3, ~ t2 0 Lv Ps "'fl City ____N _ State Lip O0 O

Ill. GENERAL CONTRACTOR

11. Name ___________ - Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name c.~'e1_ C )hi ' -- ___13. Contact Person 14. Federal Employer ID. # r15. Tel # - Fax # 16. Address OD! iD -- City J ![nU f'1~ State Zip _ L2 V. THIRD PARTY AIj2 MONITOR

17. Name _k, p? _~ Ze;2 14 1 C—_18. Contact Person V41f t i+ G N"(^Pr4 . 19. Federal Employer ID. # . _._._. PII —_ 20. Tel. # ara-'?D - 00 Fax # z. __7t7 21. Address •22 g L i2E7 City ,(4r State. `4- Zip 00 t ) 22. Sample Analysis Laboratory (t 77 (L G~A68 r tC Ttt t _23. NYS DOH ELAP # _ / l''I DSO

VI. PROJECT INFORMATION 24.. Starting date for this portion of work 17 2o— Projected completion date LZjL2 2 Z

Asbestos work schedule ❑ Monday ❑ Tuesday 0 Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from: __ 0 am 0 pm to ❑ am ❑ pm

If other, specify --~— ---____— — t\Gl.LNED Access to inspect the premises must be provided during the work schedule indicated in this item. JUN 0 52002 25. Total amount of asbestos-containing material to be abated during this work '))EP/8ANHid ti •:dESTOSit.E. PROGRAM Square Feet, and/or Linear Feet TRUG ~. ACP 7 P 2/2001 e:':Ata f

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NYC-WTC 000122993

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NYC-WTC_000122993Source: NYC Law Department, mirrored locally

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