NYC 9/11 Public Portal Document
ASBESTOS INSPECTION REPORT (continued)
26. Asbestos Hauler ASBESTOS TRANS. CO.
NYS DEC Permit # 1A-371
_Tel.# (631) 924-5050
Disposal Sito(s) IMPERIAL-P.O. 47, 11 BOGGS RD.,PA./ SOUTHERN ALLEGHANIES- VALLEYVIEW DR., PA.
27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings)
a) • Demolition
b) •Boiler Replacement
c) O Sprinkler Replacement
e) Fireproofing Replacement 1) [l Other (Describe)
d) Renovation/Alteration
28. TYPE OF ABATEMENT (Check all appropriate boxes)
• Removal
• Enclosure
Encapsulation
L Repair
• Clean up
29. ABATEMENT PROCEDURE (Check all appropriate boxes)
L Full Containment
• Glovebag
• Tent
DEP Variance Application
30. LOCATIONS OF ABATEMENT
DESCRIBE SECTION
Floor(s)
OF FLOOR
(e.g. entira, eest wing, room #.
boiler room, lobby, otc)
ROOF
ROOF
MAIN & SETBACKS
AFFECTED SURFACES
CONTAINING ACM
(e.g. Pipe lagging, colling, plenum
ducts, storsge tanks, docking, otc.)
ASPHALT ROOF
FACADE
AMOUNT OF ACM T
DESCRIPTION OF WORK BEING
SQUARE
LINEAR
FEET
PERFORMED
FEET
1,920
1,500
ITEM#1
ITEM#7
31. Ihereby declare that the information provided herein is true and complete to the best of my knowiedge. I am familiar with Federal,
State and NYC laws and regulations applicable to asbestos related work.
WARREN & PANZER ENG., P.C.
Print Name of Air Monitor
omuag
Signature
11/07/02
Date
TRIO ASBESTOS REMOVAL
Print Name of Asbestos Contractor
Sta
STEVEN PARMIGIANI
Print Name of Applicant (if ofher than Owner)
Stw
Signature
11-6-02
11-6-02
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 inaccordance 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
flling of this notification for the work specified herein.
NYC ДEP
Print Name of Oer
naMoky
Signature
11/7/02
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 directly to the NYC DEP ACP.
The requirements of theAsbestos Control Program Rules may not be lawfully avoided or lessened
through the performance of work in incremental or piecemeal fashion.
ACPT
212001
NYC-WTC_000128524
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000128524Source: NYC Law Department, mirrored locally
DEP inspection form for 50 Broadway documenting building characteristics, facade conditions, and asbestos-containing material survey across multiple building faces.