NYC 9/11 Public Portal Document
F- 6426206039 ASBESTOS INSPECTION REPORT (continued)
26. Asbestos Hauler DJM Co. Inc. NYS DEC Permit # NJ-344 Tel.# (973) 491-0006
C7 DisposalSite(s) Meadowfill Landfill, Bridgeport WV & Cumberland Landfill Shippberg, PA
27. This asbestos abatement is part of a ( Item a through a requires filing of this form with the NYC Department of Buildings)
a) ® Demolition b) ❑ Boiler Replacement Sprinkler Replacement
c) ❑ d) ❑ Renovation/Alteration
e) ❑ Fireproofing Replacement f) Q Other (Describe) Asbestos Abatement/WTC Dust Remediation
28. TYPE OF ABATEMENT (Check all appropriate boxes)
g] Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ❑ Clean up
29. ABATEMENT PROCEDURE (Check all appropriate boxes)
❑✓ Full Containment ❑ Glovebag ❑ Tent DEP Variance Application
30.LOCATIONS OF ABATEMENT
SECTION OF FLOOR AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING
Floor(s) CONTAINING ACM PERFORMED
(e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinders,
boiler room, lobby, etc.) ducts, storage tanks, decdn , etc. FEET FEET temong and readng boilers, sic)
Bsmt-5 Entire WTC Dust 9,064 Sub-Chapter G
Bsmt Entire Pipe Insulation 32 Asbestos Abatement
1 Entire Pipe Insulation 15 Asbestos Abatement
2 Entire Pipe Insulation 10 Asbestos Abatement
Roof 1st Floor Roof Roof & Flashing 146 Asbestos Abatement
Roof 5th Floor Roof Roof, Flashing & Tar 525 Asbestos Abatement
1-5 Facade Window Caulk 10 Asbestos Abatement
fl 1-5 Facade WTC Dust 8,576 WTC "Bldg Ext. Cleanup"
Roof 5th Floor Roof Coping Stone Caulk 1 Asbestos Abatement
Additional pages attached ❑
31. I hereby declare that the information povided 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.
Airtek Environmental Hazardous Elinimation Airtek Environmental
Print Name of Air Monitor Print Name of Asbestos Contractor Print Name of Applicant
Signature Signature Signature
Date Date Date
32. 1 understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for the performance of the asbestos
abatement activities in accordance with the Asbestos Control Program Rules. I have contracted the third party air monitor who is completely
independent of all parties involved in the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified
herein.
Greenwich Street Project, LLC.
Print Name of Owner Signature Date
A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.
• Any modification of information provided on this form must be reported immediately In writing directly to the NYC DEP ACP.
The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened
through the performance of work in incremental or piecemeal fashion.
L
NYC-WTC 000127793
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