Invoice from Fiber Control Inc., October 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) ` 0 ¢g 26. Asbestos Hauler t0 NYS DEC "'emit Tet. v~ Z72'37 ^ / Disposal Sites) O I 11€k Jv t,E e 5 V,f([7 fl l 27. This asbestos abatement is part of a (item a through a requires filing of this form with NYC Department of Buildings) a) 0 Demolition b) ❑ Boiler Replacement C) ❑ Sprinkler Replacement • d) ❑ Renovation/Alteration a) ❑ Fireproofing Replacement fl ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ❑ Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Giovebag ❑ Tent 0 DEP variance Application 30. LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING c-9;w,J ; Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, man Si. (e.g. Pipe logging. oeaing. Pienwm SQUARE LINEAR (e.g• funning cable, instating fire aprhkfers. room . etc) ducts tanks. deddn. etc. ' FEAT rrnoving and repladng boilers. etc

( eoaast c P L) )j

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31. t hereby declare that the Information provided herein Is true and complete to the best of my knowledge. I am familiar with Federal. State and NYC laws and regulations applicable to asbestos related work.

5Le --r ~t ~►tt c ( Print lion Name Contractor Print Na. of App mt (N other than Owner)

t . Signaturo

b~- 03--0 ? 3—o? __ Date Date Date

32.. I understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for the performance of the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have contracted the third party air Monitor who is completely independent of all parties Involved In the asbestos projecL I hereby declare that I have authorized the filing of this notification for the work specified herein. Q P,int Name d Owner signati , to

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

I[Any modification of Information provided on this form must be reported Immediately In writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the performance of work in incremental or piecemeal fashion. tricot

NYC-WTC 000123346