Invoice for facade cleanup, 150 Chambers Street

NYC 9/11 Public Portal Document

S .

ASBESTOS INSPECTION REPORT (continue) r; ;, ,~

26.' Asbestos Hauler (.o 0 NYS DEC Permit _ T —6 Tel.# 9 ^ ~ 7Z— & 7 j Disposal Site(s) U( e(LP V c c~ ► r

27. This asbestos abatement is part of a (Item a throughe requfr Irni gf this form with NYC Department of Buildings) b) QBoiler Replacement c) ❑ Sprinkler Replacemer t d) ❑ RenovatiONAlteration a) ❑Demolition a) ❑ Firepr•oofitg;Repl cerneiit ',I) ❑ Other (Describer-=

28. TYPE OF ABAYFUENT"•-(Check all appropriate boxes) ❑.Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ` P T;lean up: >,

29. ABATEMENT PROCEDURE (Check all appropriate boxes) — ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

3u. L.W%I^ r I JF yr ncP%I Gm GLLJ. DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING OF FLOOR CONTAINING ACM PERFORMED Floors) SGUARE LINEAR (e.g. wrwirg cable, installing fw sprinklers, (e.g. entire, east wing, room /, (e.g. Pipe tagging. ceiling, pier_ FEET FEET ' SSYiOinflQ and repIang boilers, tc) boiler room, lobo . et ducts, storaQe tanks, deddng, etc.)

& .

:: Tj iI

familiar with federal, 37,E I hereby deCtdfg that the information provided herein is true and complete to Jhe best ofmykrwledge ;(am g0 NYC laws and regulations applicable to asbestos related work State al

_ ( __i(~ ~ 7 _ Print N ilor P ' Name/f stag Contactor Print Nam of App .ant (If other than Qwner)

Sgnaturo gneturo Signature

~~- 03-oa rL 30 Dete - Cate Date

performance of 32. 1understand that es the owner of a building where asbestos abatement activity occurs, I am responsible for the third party air with the Asbestos Control Program Rules. I have contracted the the asbestos abatement dctivitie in accordance authorized the monitor who is completely independent of all parties involved in the asbestos project I hereby declare that I have ing f this notificatio for the rk ecified herein. . ..

&prrhxe . pall Prat Wrne ner "'E

THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT directly to the NYC DEP ACP. Any modification of information provided on this form must be reported immediately in writing lessened The requirements of the Asbestos Control Program Rules may not be lawfully avoided or through the performance of work in incremental or piecemeal fashion. ncvr 2OD1

NYC-WTC 000127167