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Asbestos Project Notification Form

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NYC DEP Asbestos Project Notification form for abatement activities at a facility in the Phase 1 Decontamination Plan binder.

NYC-WTC_000127792–000127811

Folder label: “BINDER - PHASE 1 DECONTAMINATION PLAN

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NYC 9111 Public Portal Document

7624206030 NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8th Floor, Flushing, NY 11373-5108 Building Dept. or TRU No For OFFICIAL USE ONLY ONLY TYPEWRITTEN rrr •FORMS WILL BE '~t` .. ;a` % ASBESTOS PROJECT NOTIFICATION ACCEPTED "'-+++tirlkir1`" (ASBESTOS INSPECTION REPORT)

Mien submitting this form at the NYC Department of Buildings, the original f orn and three (3) copies with original signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This form 1 $1200 nust be submitted to the NYC DEP not less than one week in advance of the start of abatement activities. (See fee schedule) I. FACILITY

2. Address 23 Thames Street Borough Manhattan Zip 10006 Premise # Prefix Street Nmne

21 Thames Street 3.Biock 52 4. Lot 8 AKA

5. Type of Facility Commercial 6. Name of Building II. BUILDING OWNER

7.Name Greenwich Street Project, LLC. 8.Contact Person Chanan Rozenbaum

9.Tel.# (347) 643-9960 Fax# (212) 208-4614 10103 10.Address 666 Fifth Avenue City New York State NY Zip III. GENERAL CONTRACTOR

11. Name Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

Hazardous Elimination Corp. 13. Contact Person Ernie Carranza 12 Name

14. Federal Employer D. #[ P11 15.Te1.# (631) 752-2898 Fax# (631) 752-2910

16. Address 195 H Central Avenue City Farmingdale State NY Zip 11735 V. THIRD PARTY AIR MONITOR

17 Name Airtek Environmental Corp. 18. Contact Person Benn Lewis

19. Federal EmployerID.# PII 20. Tel.# (212 ) 768-0516 Fax# (212 ) 768-0759 _._._._._._._._._._._._._._._._._ - 21.Address 39 West 38th Street City New York State NY Zip 10018

22. Sample Analysis Laboratory Airtek / ATC Associates 23. NYS DOH ELAP # 11040/10879 VI. PROJECT INFORMATION

24. Starting date for this portion of work Projected completion date

Asbestos work schedule: m Monday m Tuesday ® Wednesday m Thursday m Friday m Saturday ® Sunday

Shift From: ❑ am ❑ pm to ❑ am ❑ pm

If other, specify

Access to inspect the premises must be provided during the work schedule indicated in this item. • 25. Total amount of asbestos-containing material to be abated during this work

18, 322 Square Feet, andlor 57 Linear Feet 02

L J

NYC-WTC 000127792

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NYC-WTC_000127792Source: NYC Law Department, mirrored locally

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Asbestos Project Notification Form · Box DEP Box 52

NYC-WTC_000127779

NYC DEP Asbestos Project Notification form for abatement activities at a facility in the Phase 1 Decontamination Plan binder.

30 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.992

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