NYC 9/11 Public Portal Document
} DEPARTMENT OP ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard. 8" floor. Carona. NY
1136851o7
rr~ry •"zwb „~ SB•ESTQS PROJECT NOTIFICATION
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a « '-,1ASBESTOS INSPECTION REPORT)
hen zum j1Is form at the NYC t)epattment of 8ultdings, the
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a required. Submittal at the NYCDSP requires one copy
submitted to the NYC DEP not tars than one
edglnat form and Wee (3) cot
of the term with original s
weak In advance of the stud of ubateme bl
102-~ 04 ,r nw r ch
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3. Block,__ 53
__._____.__
Borough .Manhattan zip.l1)(ItI
4. Lot 37
5. Type of Facility Hardware Store /Restaurant g.
Name of Building . n/a
II. BUILDING OWNER
7. Name 109-104 (`re nwf h St M nh tan. Inc. 8. Contactperson ssa. Batx ebl
9. Tel. S. 718-439-5555 Fax # 718-439-7878
10. Addross 255 47th Street City Brooklyn
State NY .11220
III. GENERAL CONTRACTOR
11. Name CleanUazbozs
TO,# 732-248-1997
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name .,- AEi2, LLC
13. Contact Person _Bernard McKenna
14. Federal Employer ID. # P11 _._._._._. __ 15. Tot. # $ 2 2 Q _ Fax # $56-67 ,8-54"Q
16.Address 43 Jefferson Avenue Berlin
_City _ State NJ Zip JQQ9
V. THIRD PARTY AIR MONITOR
17. Name Hillmann Environmental Group, LLC
~18. Contact p Mike Nelson
19. Federal e=mployer ID. it P11 20. Tel. 0 908-686- 3335
L---•- pax # 908-686-2636
21. Address1600 Route 22 East City Union
State NJ 7.ip 07083
22. Sample Analysis Laboratory H lmann nvironmental Group, LLC 23. NYS DOH ELAP 10926
#
VL PROJECT INFORMATION
24. Starting date for this portion or work 12/3/01
Projected completion date 12 / 2 4 / 01
Asbestos work schedule I Monday U1 Tuesday © Wednesday 13 Thursday IN
Friday ❑ Saturday 0 Sunday
Shift Irom:.&QQ_.... 0 am Q pm to .—.2;_OQ
I] am Q pm
~1101
If other. I~~,
specify 1b
Access to inspect the pronrlses must he provided dtlring
the work schedule indicated in this itont. h ~ ~ ~VLU , -
DEC 1
25. Total amount of asbestos-containing material to be
abated during this work c= BAPtiNt.
cO == TCS t _
? 6.000 l Square Feet,
and/or Linear Foot r
RUG
N/7 rç ~ACp7
212001
NYC-WTC 000128594
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