Invoice for roof remediation work, 123 Fulton Street, Jul 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) 1 26. Asbestos Hauler IESI,NY ` NYS DEC Permit # • N4"~ 2 , Tel.# {718) 522-2263 Disposal Site(s) 8!! '°9 Landfill PO Box 399 Scotsdale, Pa 17254

27. This asbestos abalrwent is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) 0 Demolition b) ❑ Boller Replacement c) ❑ Sprinkler Replacement d) ❑ Reno n/Aiteratton e) ❑ Fireproofing Replacement f) El Other (Describe) 28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure ❑ Encapsulation 0 Repair Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application (JP3IV ~ 2 30. LOCATIONS OF ORA mat=,rr O n rC PA,... -n DESCRIBE SECTION . •~•--••••. ruv~- m Ierzs►n)E. C.-Thiz AFFECTED SURFACES AMOUNT OF ACM Floor(s) OF FLOOR DESCRIPTION OF WORK BEING (e.g. entire. east wing, roan S. CONTAINING ACM (e.g. Pipe using. ceiling. plenum SQUARE UNEAR PERFORMED boiler mom etc) ducts FEET (e.g running cable. Installing fie sprinklers. tanks. deddnq, eta) FEET ROOF Wort S I- ot3 14SO Bc)c.ic 1&+`vs 350 tt ! Sou nit Seeno t t J450 _ ~4 tas 3S0

31.. 1 hereby declare that the information provided herein Is true and complete to the best of my State and NYC laws and regulations applicable to knowledge. I am familiar with Federal, asbestos related work.

2&eW fc Lkgizz),*Ns. Print Name of Ak Monitor Name of Asbes Contractor Print Name of Applicant (It other than Owner)

,$gna5jre ( 79nature Signature

32. 1 understand that as the owner of a building where the asbestos abatement activities in accordance asbestos abatement activity occurs, I am responsible for the performance of with the Asbestos Control Program Rules. I have monitor who Iscompletely independent of all parties involved in the a stns contracted the third party air filing of this notification for the work specified herein. project. I hereby declare that I have authorized the

Ptittt Name of Owner — uae ve? b6 112102 Date A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. ification of information rovided on this form must be reported imm jajjly in writing direct! to ttte 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 nr nia.~.,,cm s ►.:.... ACP7 212001

NYC-WTC 000127827