Asbestos removal invoice, 67 Greenwich Street, June 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTIO.N~r REPORT (continued) Asbestos Transportation I 26. Asbestos Hauler c' NYS DEC Permit # 1A-371 TEL# 631) 9245050 - DisposalSite(s) Imperial/P.O. Box 47, 11 Boggs Rd.PA; Southern Alleghenies/Rd 3 Box 310 Valleyview PA 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) ❑ Bolter Replacement c) ❑ Sprinklpr Replacement d) 0 RenovationlAlteratlon 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) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

30. LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire,,eat wing, room #. (e g. foe tagging. ceting. plenum ARE (e.g. mm~ing cable. instating lire sprinklers. boiler room, ducts, storage tanks. , etc SE U r N and repladng boilers. etc.) 28 Trinity oof Item No. .1 1,450 oof Item No. 4 800 galls Item No. 7 2,475

67 Greenwich oof Item No. 2 3,.200 Walls Item No. 7 390 Facad Item No. 7 2,500

31: t 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.

Warren & Panzer Trio Asbestos Removal NYC Print are of Motutor Pd r Asbes_ s Strad Orp . Print Name of Appacant (H other than Owner) /, .~

Signature Signature Signature f

Date Oate 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. 67 Greenwich LLC c/o NYC Prod 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 direct!y to the NYC DEP ACP. of the Rules t•r ACP7 uqh the

NYC-WTC 000128264