Asbestos project notification, 80 Gold Street, Oct 2001

NYC 9/11 Public Portal Document

, ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler I FS I , NYS DEC Permit # _tai - 462 Tel.# (.118) S22-223

t.AND F tLL- PO BOX 39 PA► i;?254 Disposal Site(s) BWE RIDGE of Buildings) 27. This asbestos abatement is part of a (Item a through a requires filing of this form with NYC Department b) ❑ Boiler Replacement C) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration a) 0 Demolition e) ❑ Fireproofing Replacement f) ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ® Cleanup

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ l=ull Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application'

3U. LV-:A I lvNO yr Horst r-man t .%I—w -^ • - — AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING DESCRIBE SECTION PERFORMED Floor(s) OF FLOOR CONTAINING ACM LINEAR (e.g. entire, east wing. room #, (e.g. Pipe tagging, ceiling, plenum SQUARE (e.Ø. running cable. installing fire sprinklers, FEET FEET removing and replacing boilers. etc.) boiler room, lobby. etc) ducts, storage tanks, decking, etc.)

RooF Roof Saa.tVAcE egos

of my knowledge. I am familiar with Federal, 31. I hereby declare that the information provided herein is true and complete to the best c+pro anti mV(: lave anti rant tintinn-st annlicable to asbestos related work.

U314"C-4 ~ 42EQ. Eio6 tins S. tcu2ZBAS # Sees Corsr1zo4 Print ame of Asbestos Contractor Print Name of Applicant (If other than Owner) Print Name of Air Monitor

o.~-. Signature Signature Signature

a?~og.~ eay c~7-OS-G2. Date Date Date

occurs, I am responsible for the performance of 32. I understand that as the owner of a building where asbestos.abatement activity Rules. I have contracted the third party air the asbestos abatement activities in accordance with the Asbestos Control Program hereby declare that I have authorized the monitor who is completely independent of all parties involved in the asbestos project. I filing of this notification for the work specified herein. NYC De^p 0 7-O B-O Z Signature Date Print Name of Owner AVAILABLE AT THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE ACP. be reported immediately in writing directly to the.NYC DEP [Any modification of information provided on this form must lawfully avoided or lessened The requirements of the Asbestos Control Program Rules may not be fashion. through the performance of work In incremental or piecemeal ~t

NYC-WTC 000128147