NYC 9/11 Public Portal Document
—,•• • y, ' YC DEPARTMENT OF ENVIRONMENTAL PROTECTION
r•4 ~+° .r Asbestos Control Program
f. 50-17 Junction Boulevard. 8" Floor. Corona. NY 11368.5107
SBF-STOS PROJECT NOTIFICATION
:ASBESTOS INSPECTION REPORT)
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form at the NYC fflo rnent of Buildings, the odginat tam and three (3) cc
a required. Submittal at the NYCOEP requires one copy of the form rwlh odgkwl
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ust be submitted to the NYC DEP not loss than one week In advance of the sled of abatem
TAKA 3. Block .-... 5 3 4. Lot 37
5. Type of Fatuity Hardware Store /Restaurant 6. Name of Building n/a
II. BUILDING OWNER
7. Name 102-104 Groan is'1St Manhattan. Inc. 8. Conti Person Essa' Bateb
9. Tel.tt 718-439-5555 Fax# 718-439-7878
10.Addross 255 47th Street City Brooklyn s ta te Yap . 1112220
III. GENERAL CONTRACTOR
11.Namo Clean Harbors Tel.# 732-248-1997
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name AEi2 , LLC 13. Contact parson Bernard McKenna __._.
14. Federal Employer ID. It PI I_ ..-_ 15. Tot. # 856-768-9200 Fax # 6.8-5499
16. Address 43 Jefferson Avenue _ City Berlin State NJ zip 08009
V. THIRD PARTY AIR MONITOR
17. Name Hillmann Environmental Group, LLC -_18. Conta~l p Mike Nelson
10. Federal Employer ID. f ._._._._._._._ PI1. 20 Tel # 908-686- 3335 Fax # 908-686-2636
21. Address 1600 Route 22 East City Union State NJ p _07083
22. Sample Analysis Laboratory IEillmann Environmental Group, LLC 23. NY$ DOH Et.AP # 10926
VI. PROJECT INFORMATION
24. Starting data for this portion of work 12 / 3 / 01 projected completion data
Asbestos work schedule 1i Monday EI Tuesday Q Wednesday Q Thursday IB Friday D Saturday D Sunday
Shift lrom:. i 00 Dam pm to 2:0 D' am D pm 9 10
it other, ~
specify
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Access to in••pact flue promises nwst tea prvvfdod during the work schedule indicated in this HUM t\
DEC 1 1 2001
25. Total amount of asbestos-containing material to be abated during this work `q = ~'E A i~ ' •"•'
- ST0S LE;
° T vhntt
26.000_._ Square Foot, and/or — Linear Foot i Tai.t'a
NYC-WTC 000128550
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