NYC 9/11 Public Portal Document
NYC DEPARTMEN'P OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY
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• Asbestos Control Program
59-17 Junction Boulevard, 8"' Floor, Corona, NY 11368-5107
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Amendment
FORMS BE ASBESTOS PROJECT AMENDMENT FORM Information Only. 0 Yes CJ No
ACCEPTED •w w•nrc.te•!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# 0&
(a M 1P'Facility Address t 4 3. C t& S &f Borough II31_zip _it''~
Date ACP7 was filed Variance # (If any)
Was this ACP7 amended before? ❑ Yes Ilo If yes, specify date
0
Original Start Date 1
j I1+ D')— Original Completion Date_RJ
PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED:
from ACP 7, #24.
A notification may be modified no more than twice.
Only the building owner may amend items IV and V.
The original applicant or building owner may amend all other items.
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name _ t 13. Contact Person t a' ?%v1 CAQ 1 A
14. Federal Employer ID. #L P 15. Tel. 461 L) 7' I " 3iDODFax SLJJ 1s j 3Dg.~
16. Address 301 & L4. s $ I & E' "0A F- City State • -i Zip -%
V. THIRD PARTY AIR MONITOR
17. Name 3 L P '"c T' Zz 0. X1,€ii.t, f G 18. Contact Person _M t CH-NEt. 0P
19. Federal Employer ID. # 20. Tel. i y4 r } Z'1" '0
o17 Fax #4)3 51 ) — O{o 3
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21. Address & S aD City _t • -k StatJ% Zip 00`
22. Sample Analysis Laboratory SCrc.NL ty% C_ Y.ih4.%gAtt e Q1~ Pte3. NYs DOH ELAP #_U 9."
VI. PROJECT INFORMATION ❑ Project Cancelled
24. Starting date for this portion of work 0 > Projected completion date i41J Z ❑ Project Postponed
Asbestos work schedule 0 Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday _❑Sunday
Shift from: ❑ am ❑ pm to ❑ am 0 pm If other, specify, 10
25. Additional asbestos-containing material to be disturbed during this work .ISO Square F an ine e
Reduction in the amount of ACM to be disturbed during this work Squareii , an ear
29. Abatement Procedure for Additional Material (Check all appropriate boxes) aF
❑ Full Containment 0 Glovebag ❑ Tent 0 DEP Variance Application r`
Other Changes
30. Locations of abatement modified by above '- -! `f
(For each floor list ACM quantity~and type) - '
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31/32. Name of Applicant / Owner 7
rL-P i a +..' Tel. #____________________
Name of Company (If any) - Fax #
Address City State Zip
I hereby declare that the information provided herein is true and complete. ( 02 -
aE~; Sign re of Applicant /Owner Date
of y0 1aot ACP8
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NYC-WTC 000127239
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