Invoice from Fiber Control Inc., 189 Broadway, Dec 2002

NYC 9/11 Public Portal Document ,~ NYC DEPARTMENT UP ttvvitv, ,v,cn, . ,. rav, Asbestos Control Program a/

°TYPEWRITTEN YL PE . ~ .~`' ASBESTOS PROJECT NOTIFICATION FORMS WILL BE -- c3le.i (ASBESTOS INSPECTION REPORT) 1. ACCEPTED original form and three (3) copies with original When submitting this form at the NYC Department of Buildings, thecopy signatures are required. Submittal at the NYCDEP requires one 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 r3P.M 4 w , ' Borough N /_Zip OO O 2. Address _ 1.- 3 DE( s %2 EE f 3. Block (03 4. Lot /3 AKa 5. Type of Facility 6. Name of Building

(1. BUILDING OWNER f"Ji 8. Contact Person 7. Name nV f

9. Tel. # Fax #

10. Address 1/ Cep U-- City, state N` zip _f Ill. GENERAL CONTRACTOR Tei. # 11. Name

IV. ASBESTOS ABATEMENT CONTRACTOR ~/ / ,, 13. Contact Person ~7~ t -4 12. Name ~ t & f -12 -( 1( a PII J~T 7ej- 3000 Faxk V _( 7&/- 14. Federal Employer ID. #1 r._~-~-~~-~-~-~-~-~-~-~-~-~--~-_~-!IS. Tel. 16. Address aI _ city w _~A state = zlp ti

•, VL.THIRD.PARTY AIR MONITOR j 17. Name ~}1~-{ ailo2~ P,A-IJZ 2 ngrr, Pars. ~G 18. Contact Person r-1/~/j/Gf ~-7' ` p " • M8 t 4

19. Federal Employer !D. # 20. Tei. f~~ ) 1 0O7 / Fax #ice `7 a

5 :S0 city N ~t State zp '0 l 21. Address _ t 22. Sample Analysis Laboratory S / i G Q ro2( L~C23. NYS DON ELAP # VI. PROJECT INFORMATION 24 Starting date for this portion of work - Projected completion date ` /) 0 Sunday Asbestos work schedule 0 Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑

Shift from: ❑ am ❑ pm to ❑ am ❑ pm

If other. 4 specify fCELVED schedule Indicated in this Item. I [Access to inspect the premises must be provided ding the work `,NOV 2'5 2002': during this work 25. Total amount of asbestos-containing material to be abated 0Square Feet, and/or Linear Feet ACP V200

NYC-WTC 000123048