NYC 9/11 Public Portal Document
FOZA WTC
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONLY
DEP
Asbgstos Control Program "
59-17 Juńiction Bouiovard, 8*' Floor, Corona, NY 11368-5107
ON
ILL BE
TED
OHANTA, PROTETGA
ASBESTOS PROJECT NOTIFICATION
www.syc.gov/dep
(ASBESTOS INSPECTION REPORT)
Th10883MN02
Bullding Dept. or TRU No
FOR OFFICIAL USE ONLY
1..
E
«Seo fee schedlule)
When submitting this form at the NYC Department of Bulldings, the original form and three (3) copies with original
signatures are required.
Submittal at the NYCDEP requires one copy of the form with original signatures.
This
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.
I. FACILITY
2. Address
123 Fulton St
AKA 46 Ann St, 121 Fulton St
5. Type of Facility_
Il. BUILDING OWNER
7. Name Cedar Managaement Corp
9. Tel. # (212) 732-7653
Fax#
10. Address
III. GENERAL CONTRACTOR
11. Name_
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name.
Benjamin Kurzban & Son Control
14. Federal Employer ID. #i.
16. Address_
1248 Ralph Avenue
V. THIRD PARTY AIR MONITOR
_ 17. Name Warren & PanzER ENGINEERS
19. Federal Employer ID. $
PII
..I.IT
21. Address _
228 East 45th St
Borough Manhattan
_ 3. Block.
91
_ Zip
_ 4. Lot.
9
6. Name of Bullding
8. Contact Person
City
State
-Zp-
_ Tel. #
_ 13. Contact Person Louie lannico
15. Tel. # (718) 531-2900
_ Fax# (718) 209-1808
..City Brooklyn
_ State NY
Zp _11236
INC
_18. Contact Person _MICHAEL
NOLAN
.20. Tel.# (212) 922-0077
_ Fax # (212) 922-0630
_City_New York
_ State NY
_Zip_10017
22. Sample Analysis Laboratory.
VI. PROJECT INFORMATION
_ 23. NYS DOH ELAP #_
24. Starting date for this portion of work
Asbestos work schedule
06/11/02
Profeoctod completon data_ 07 /,7/02
•Monday
•Tuesday •Wednesday • Thursday Friday Saturday • Sunday
Shift from:
• am •pm
to
• am •pm
If other,
specify
10
Access to inspect the premises must be provided during the work schedule indicatod in this itom.
25. Total amount of asbestos-containing material to be abated during this work
3600 square Feet, andor
O_ Linear Feet
/
RECEIVED
JUN 1 3 2002
"SP/BANHN
3ESTOS/LE+.
PROGRAM
TRUG
2
21
ACP 7
212001
NYC-WTC_000127826
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000127826Source: NYC Law Department, mirrored locally