Invoice from Fiber Control, Inc., August 2002

NYC 9/11 Public Portal Document

ASBESTOS 1NSPECTF PEORT > (continued) —• :272 26. Asbestos Hauler_(-D r7 NYS DEC Permit C - 0. _ Tel.; ~ ~/ ,~6f

Disposal Site(s) _ OI 2k N [E ~! e s rf F ,1

27. This asbestos abatement is part of a (Item a through a requires filing of this form with NYC Department of Buildings) a) 0 Demolition b) 0 Boiler Replacement c) 0 Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement t) ❑ Other (Describe) —

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment 0 Glovebag ❑ Tent ❑DEP Variance Application /; / t I//p (/%~~/~/~//~~ / ~ J ~✓ ~ . A/. a7IA\IP nr an aTrue►,.' ,/ 7' ; ! / I / U ~ ~V I" JV Ivv^ DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION'OF WO K BEING Floor(s) I OF FLOOR CONTAINING ACM PERFORMED SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room #, (e.g. Pipe lagging. ceiling. Plenum FEET ducts, storage tanks, decking. etc.) FEET removi and re laci boilers, etc.) boiler room. lobby. etc) tc l J~'^ -0 cçcp t, ( t —L. "~

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Federal, 31. I hereby declare that the information provided herein is true and complete to the best of my knowledge. I am familiar with State and NYC laws and reoulations aoDlicable to asbestos related work. v

Print N itor Prin Name f As C' ,~ stns Contractor 23Th Pnnt Nam of App sr&- nt (If other than Owner)

r( t -72e . \

re ~~- 03 0~ Signatu _ -off gnature

` 3-~z Signature

Date Date Date

for the performance of 32. 1 understand that as the owner of a building where asbestos abatement activity occurs. I am responsible contracted the third party air the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have declare that I have authorized the mop. Who is completely independent of all parties involved In the asbestos project. I hereby f' f this notificatio r the k specified herein. 0~ ~_ Signature ~D to Pnit Name of ne{ AVAILABLE AT THE WORK SITE. Y' I TAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE

lawfully avoided or lessened The requirements of the Asbestos Control Program Rules may not be fashion. i+cPr through the performance of work in incremental or piecemeal artoot

NYC-WTC 000127372