Asbestos abatement invoice, 198 Broadway, Aug 2002

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8°i Floor, Corona,'NY 11388-5107

~ Nt11t ~~6 ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) i:rw.ny~,~e leer. EP7ED

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 19 __,•~}R,Q AD W A9 Borough MN Zip 2. Address _ 3. Block 79 4. Lot 18 AKA

5. Type of Facility_ 0MM E1LC1 A.L — 6. Name of Building

II. BUILDING OWNER 7. Name Qo t l.rrA l ATE 01 1 a:CA Co eP'. 8. Contact Person

9. Tel. # ,L2t31 233-1960 Fax# . —

10. Address _45 Jolt S•rRTeE-r _ City Niw Yo¢tc_ _ State N~?_ Zip J _ Y_ 111. GENERAL CONTRACTOR

11. Name_ _ Tel. # _— -

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name b3 AMtat YVE28AN ¢ Soa totiTEoL tae. _13. Contact Person _ fE I►autco ,______

14. Federal Employer ID. PII 15. Tel. # (1(8)531-29 Fax

16. Address 12 A9 RAt~P11 AVE,3V E City BROOK ± _ State N __ Zip _jib _

V. THIRD PARTY AIR MONITOR

17. Name WAt EN_ ~` ~pAN2zETL ENglavE s {t+1C. 18. Contact Person M I t'.itAIMr_ Ntar.A~t 19. Federal Employer ID. # 20. Tel. # 02121 922- oc*TT ___ Fax # (212) 922— cs53a! ~_

21. Address _ 2 2 EAst dS ri1 5ttz r _.__ City New 'IIs2SL State N _ Zip 1OOiT __-_

22. Sample Analysis Laboratory_______________________________________ 23. NYS DOH ELAP # VI. PROJECT INFORMATION 24_ Starting date for this portion of work - ~ 8"f T_a 2 Projected completion date _9L .LO Z

Asbestos work schedule ® Monday IN Tuesday 13 Wednesday ® Thursday ® Friday © Saturday ® Sunday

Shift from: - S°Q ® am ❑ pm to e ❑ am ® pm

If other, specify _ _--- Access to inspect the premises must be provided during the work schedule Indicated In this Item.

25. Total amount of asbestos-containing material to be abated during this work s • .488 Square Feet, and/or _ _ O Linear Feet ACP V2OC

NYC-WTC 000123201