Invoice for fiber control services, 154 Chambers St, July 2002

NYC 9/11 Public Portal Document

DEP ECB Fax:212-361-1433 Jun 28 2002 11:25 P.05 s

ASBESTOS INSPECTION REPORT (cc 7 28. Asbestos Hauler NY$ DEC Permit I __ 1•14 !.I2'_ c'

Disposal Site(s)

27. This asbestos abatement is part of a (item a through a requires filing of this form with NYC Department of Buildings) e) ❑ Demolition b) Cl Boller Replacement c) ❑ Sprinkler Replacement d) Q Renovation/Alteration e) ❑ Fireproofing Replacement Q ❑ Other (Describe) __ . —~

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure ❑ Encapsulation 0 Repair D Clean up

29. ABATEMENT PROCEDURE (Check all appropriate boxes) 0 Full Containment ❑ Glovebag 0 Tent ❑ DEP Variance Application y / J DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. enure, as it wing, room S, (a.g. Pipe lagging, ;sling, plenum 3QVARE UNEAR it g• running cable. installing fire sprinkler, lien room, bb , etc) duds, tore , g• o, ic. FEET FEET r.movlro and 01CiIQ

31. I 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.

Contractor PM: Nan or App nt (if other than Owner)

Signature 7gnatu 1

32. 1 understand that as the owner of a building where asbestos abatement activity occurs. I am responsible for the performance of with the Asbestos Control Program Rules. I have contracted the third party air the asbestos abatement activities in accordance I have authorized the monitor who is completely independent of all ponies involved In the asbestos project. I hereby declare that filing of this notification for the work specified herein.. Oete Prini Nyne 0r Owrlar

AT THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE Wflllflg directly to the NYC pP ACP. Any m ification of information rovlded on thIs f rm mUst be reported immediate in ,cP,

NYC-WTC 000127095