NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION r~
Asbestos Control Program ,#tmEL.0 k
59-17 Junction Boulevard, 8th Floor, Corona, NY 11368.5107+
ASBESTOS PROJECT NOTIFICATION
r BuDding
F OFFGAL
atTF
•.. ,.r..p (ASBESTOS INSPECTION REPORT) 1.
ACCEPTED -
(See fee E
When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.
1. FACILITY
2. Address 114 - UG FOt OI Borough Zip
AKA 3. Block 4. Lot
5. Type of Facility 6. Name of Building
II. BUILDING OWNER
• 7. Name CEP Alt M AN AG EM'E1JT ' 8. Contact Person
9. Tel. # (212) TS2 - T653 Fax #
10. Address 2O Ve 55 S11z ET City 1343 State 1f Y Zip
Ill. GENERAL CONTRACTOR
r
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name B iPM43 Ku(Z28A S 4 Sop io,JT c L INC 13. Contact Person 1_OutE 1140MI CO
14. Federal Employer ID. # 15. Tel. #. C2it3} S31-2903 __ Fax # C Ir8) 209 1808
16. Address 1248 2 -'Pty AVEEaut= City Beoo6ct-YN State NY Zip tI236
V. THIRD PARTY AIR MONITOR
17. Name l )AR.1?. 4 PI ANzt=. ( e- 18. Contact Person )A%CUAEL NOt-p,EJ
19. Federal Employer ID. # 20. Tel. # C2 r2) 922 - TT Fax# C2-1z) 922.-0630
21. Address 226 FA8r 4 i5 T11 TT - T City Py State MY Zip 1 OOIZ
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VI. PROJECT INFORMATION ,
24.. Starting date for this portion of work Oa Projected completion date7/i'fa 2
Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday
Shift from: ❑ am ❑ pm to ❑ am ❑ pm •
6
Lx
if other,
Specify _
Access to Inspect the premises must be provided `during tihe work schedule indicated in this item. JUN t 8 2002
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N OE&B N
25. Total amount of asbestos-containing material to be abated during this work
SPR~tEAG
!3 3 2 Square Feet, and/or Linear Feet / T2 G .
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~'.~~lr 7 EMrtROt*i~rr
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NYC-WTC 000128812
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