Asbestos project notification form, 100 Church Street

NYC 9/11 Public Portal Document

✓'fJTY Wy .-~ NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY Asbestos Control Program F an 37 59-17 Junction Boulevard, 8'" Floor, Corona, NY 11368-5107 ONLY MW ~ i TYPEWRITTEN \y " Amendment FORMS WILL BE ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes 0 No ACCEPTED " _ 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# , - / M 'J Address 1 O CD C1 t IA (tC_i-( Sr Borough ry l Zip I t O C`

Date ACP7 was filed D )3 Oy Variance # (If any)

Was this ACP7 amended before? ❑ Yes No If yes, specify date DL Original Start Date `~ Original Completion Date D1 -from ACP 7, #24.

PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: I A notification may be modified no more than twice. Only the building owner may amend ti ems IV and V. The original applicant or building owner may amend all other items. IV. ASBESTOS ABATEMENT CONTRACTOR r-~ 12. Name Fit t"-€ r l~ _1 )-13. Contact Person F ,o (( 7 (~C) 14. Federal Employer ID. PII ' 15. Tel. # ~ #~ 16. Address O1O (f ~wi v $L ? J- - --~L- City I -P~ 1* State ~ Zip _

V. THIRD PARTY AIR MONITOR n ,~ ^ - p 17. Name rQ..p ~ h11~ f rn1`z~e- FA4 ALB r PL. 18. Contact Person 1kI (.Vn l I L-

19. Federal Employer ID. # 20. Tel. # ( 'i_>9 ) 71 Fax # ' _ O( ?

21. Address S. City N` State ,~ *' kZip t ac 9—

22. Sample Analysis Laboratory ~ C. ~RJ ~C-23. NYS DOH ELAP # I \ U-' ' VI. PROJECT INFORMATION ❑ Project Cancelled 24. Starting date for this portion of work I Projected completion date I oZ 0 Project Postponed

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

Shift from: ❑ am ❑ pm to ❑ am ❑ pm If other, specify

25. Additional asbestos-containing material to be disturbed during this work 5o L- Square nd/o ' j.inear 'Fet

Reduction in the amount of ACM to be disturbed during this work Square r.ILLllllttll~t 29. Abatement Procedure for Additional Material (Check all appropriate boxes) C c 3 'Shmt 0 Full Containment ❑ Glovebag 0 Tent 0 DEP Variance Application r.S3:5TGS,LE p PftTRUGfd Other Changes p v_ 30. Locations of abatement modified by above A I k. S y- '1_ ' (For each floor list ACM quantity a )

31/32. Name of Applicant / Owner - Tel. #_~I ~ Name of Company (If any) (' ~--li c Fax #

Address City State Zip

I hereby declare that the information provided herein is true and complete. 4f~ ` ~—" I` O'er Signature of Applicant /Owner Date ACP 8 u'REW M EM E r~RtyrlA VM ;.-.r'.Atri: i ENrOR.1MEM Y ~ Toss CONTROL . ?tST 'C, ,

NYC-WTC 000126771