Invoice for asbestos removal, 211 Broadway, July 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) d -• Asbestos 26. Asbestos Hauler Transportation Co. NYS DEC Pernut # 1 A-371 TEL.# 631-924-5050 DisposalSite(s)_Imperial/POB 47, 11 Boggs Rd., PA: Southern Alleghenies Valleyview Dr., PA 27. This asbestos abatement Is part of a (item a through e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) 0 Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement t) ❑ 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 ❑ Glovebag ❑ Tent ❑ DEP Variance Application ~✓ 30. LOCATIONS OF ABATEMENT if tJ i' #l NV/~ V DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, room #, (e.g. Pipe tagging. ceiling, plenum SQUARE LINEAR FEET (eg• running cable, installing lire sprinklers. boiler room, lobby. etc) ducts.storage tanks, decking. etc.) FEET removing and replacIng bolters. etc.)

Facade Item No. 8 Facades 4300

31. 1 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.

Warren & Panzer Trio Asbestos Rvl.Crp. NYC Print Name of Air Mondor P ' t Nart~,of A;b s Contractor Print Name of ApeS (N other than Owner)

ignature S Signature Signature

r-- Date Date Date

32. t understand that as the owner of a building where asbestos abatement ctivity occurs, I am responsible for the performance of the asbestos abatement activities in accordance with the Asbestos Co r I Pro ram Rules. I have contracted the third party air monitor who is completely independent of all parties involved th as t j I. hereby declare that I have authorized the filing of this notification for the work specified herein. c/o NYC 1f2 , L Print Name of Owner Signature Date

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

.ny modification of information provided on this form must be reported immediately In writing directly to the NYC DEP ACP. j The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened ACP7 through the performance of vork in incremental or piecemeal fashion. J 2/2001

NYC-WTC 000123628