NYC 9/11 Public Portal Document
E -o1 NYC DEPARTMENT ENVIRONENTAL PROTECTION
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59.17 Junction Boulevard, 8th Floor, Cbrons, NY 11388-5107
ONLY ((DP Ply CT NOTIFICATION
BulbO Dept. arE ON
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FORMS
YG
-jTiSECON REPORT) 1 $1200
(See fee schedule)
When submlttlnij this form ? U NfC iM e nt of Bu s, the original form and three (3) copies with original
signatures are rpqulred. Submittal at the NYCDEP req one copy of the form with original signatures. This
form must be sibaitad fo the NYC DEP not less than on "Meek in advance of the start of abatement activities.
Address 217 BROADWAY Borough Manhattan Zip 10007
i AKA
5. Type of Facility Commercial 6. Name of Building
3. Block 88 4. Lot 1
11. BUILDING OWNER
7. Name Columbus Properties 8. Contact Person J. DiMurro
9. Tel. # (212) 732-0916 Fax# (212) 732-1157
40. Address 217 Broadway City New York State NY Zip 10007
III. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name AA SERVICES, LLC 13. Contact Person J. RENSINK
14. Federal Employer ID. #-------P ~.----- 15. Tei. # (845) 782-4443 Fax # (845) 782-1872
16. Address 36 EAGLE STREET City MONROE State NY Zip 10950
V. THIRD PARTY AIR MONITOR
17. Name A.E.C.C. 18. Contact Person Anthony Novicki Jr.
20. Tel. # (631) 589-3666 Fax # (631) 589-4004
21. Address 1302 Walnut Avenue City Bohemia State NY Zip 11716
22. Sample Analysis Laboratory Scientific Laboratories 23. NYS DOH ELAP # 11480
VL PROJECT INFORMATION
24. Starting date for this portion of work 9/25/01 Projected completion date 9/30/01
Asbestos work schedule ❑ Monday © Tuesday`•© Wednesday ® Thursday © Friday 0 ® Sunday
Shift from: 7 E am ❑ pm to 7 ❑ am El pm
If other,
specify
Access to Inspect the premises must be provided during the work schedule IndIceledin this Item.
SEP 2
25. Total amount of asbestos-containing material to be abated during this work
1 GO 0 Square Feet, and/or 0 Unear Feet <<
ACP 7
\\, 212001
NYC-WTC 000123314
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