Document label for 127 Fulton Street WTC debris file, 2002

NYC 9/11 Public Portal Document

1.2 Z FOc.TOt4 S-rf2ET ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler _IESI,NY NYS DEC Permit # NJ-462 Tel.# (718) 522-?263 Disposal Sit(s) BlueRidge Landfill PO Box 399 Scotsdale, Pa 17254

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

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure ❑ Encapsulation ❑ Repair ® Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) l2 ❑ "Full Containment 0 Glovebag ❑ Tent ❑ DEP Variance Application (•,7

30. LOCATIONS OF ABATEMENT QO r Li A t.e,L • ex3tw aA C -mv, DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM (e.g. entire. east wing, room #. (e.g. Pipe tagging, ceiling, plenum SQUARE LINEAR PERFORMED boiler room, lobby, etc) FEET andte, installing fire s enk)ers, (e.g. running cab duds, storage tanks. decking,eta FEET and r act boilers, etc. ROOF BACIc roeiioe. (Aid. 2Soo >Q F ~rA'. %XX traps tt µ IOIDLE PopX10#a 5*.Aetc Sees 6W.Au) stur~ie i~Ae's1At ~OF It8Y roestPAi>itAi) PaeAeEt f lash Ca M

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31. I hereby declare that the information provided 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.

WA2RE~3 ~l RN2~R ENGt~uL 5 KBAN i sw CaOT14L __ _ Print Name of Air Monitor Print me of Asbestos Contractor Print Name of Applicant (If other than Owner)

c-c Signature Signature Signature --

077116 cs2. CC It6t12.. Date Date Date

32. I 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. P/

Print Name of Owner .may JYe PEP a't 16102. Signature Late A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. modification of information provided on this form must be reported immediate!y in writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened AO'7 2/2001

NYC-WTC 000127922