Asbestos project notification form, 100 Church Street area, undated

NYC 9/11 Public Portal Document

A '+ "`"D0'"' y NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY Asbestos Control Program Feehf any)$ 59-17 Junction Boulevard. 8 Floor. Corona, NY 11368-5107 iLY Q 00 I _=X37 Amendment FORMS WILL B BE ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes ❑ No ACCEPTED .,..~7 .~o.~a.o FOR FORM ACP 7 A modification is valid only If it is received by the NYCDEP prior to the previously filed date of completion, except for start date changes that must be received by the original start date.

ACP7 TRUBN# , -5'1Mafiya 1cIi Address I C) C C t k 2C-1'4 S' Borough Zip l O O O

Date ACP7 was filed >-3 O'Y Variance # (If any)

Was this ACP7 amended before? ❑ Yes E No If yes, specify date

Original Start Date Original Completion Date p l\_ -h'6m ACP 7, #24.

PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified no more than twice. Only the building owner may amend items IV and V. N. ASBESTOS ABATEMENT CONTRACTOR The original applicant or building owner may amend all other items.

12. Name I x.21 1. '~ 13. Contact Person Rorz)--t ( ~S P

14. Federal Employer ID. #1._._._._._. IPI . . ~ 15. Tel. # _ Tt b) 7 ~i -3~ ax #sue►1 Y? I_- 16. Address = P I t` ,rig A.- City W-Pr'i 1r * State Zip

V. THIRD PARTY AIR MONITOR ,~ A _ n (~ 17. Name Q~~1>[ f 1 . - ~,, 18. Contact Person 1L) Can

19. Federal Employer ID. # 20. Tel. # -L^OO71 Fax#

21. Address City t-' ' y State 1J ' \Zip _9 . 22. Sample Analysis _ -_ NYS DOH ELAP #_\ U C)

VI. PROJECT INFORMATION ❑ Project Cancelled 24. Starting date for this portion of work _11 Projected completion date oZ ❑ Project Postponed

Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday 0 Thursday 0 Friday ❑ Saturday 0 Sunday

Shift from: ❑ am ❑ pm to ❑ am 0 pm If other, specify P~ 25. Additional asbestos-containing material to be disturbed during this work i4 Square rd/orr

Reduction in the amount of ACM to be disturbed during this work Square _ee anci~fc ITT 29. Abatement Procedure for Additional Material (Check all appropriate boxes) c EP p4F1hE 0 Full Containment 0 Glovebag 0 Tent ❑ DEP Variance Application

Other Changes 9 `o 8 30. Locations of abatement modified by above A I Q. S L (For each floor list ACM quantity

31/32. Name of Applicant / Owner r`~' Tel.

Name of Company (If any) Fax #

Address City State Zip

I hereby declare that the information provided herein is true and complete. Il I O,~

Signature of Applicant /Owner Da(e JtP ACPS a RE~U M E E~ 21 1 .: Ti .'hA1 L U 1Ol NA

NYC-WTC 000126546