NYC 9/11 Public Portal Document
~I~l Ir y NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8°i Floor, Corona, NY 11388-5107 a
DP ASBESTOS PROJECT NOTIFICATION
FOR CRF1CaL NOE ONLY
BE
c. a de
(ASBESTOS INSPECTION REPORT) 1
TED W..a
(S..10s
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.
L FACILITY
2. Address 118 Fulton St Borough Manhattan Zip
..3. Block 78 4. Lot 46
5. Type of Facility 6. Name of Building
II. BUILDING OWNER
7. Name 120 Fulton St LLC 8. Contact Person
9. Tel.# Fax#
10. Address City State Zip
111. GENERAL CONTRACTOR
11. Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannioo
II
14. Federal Employer ID. #1--------.-.P 15. Tel. # (718) 531-2900 Fax # (718) 209-1808
16. Address 1248 Ralph Avenue City Brooklyn State NY Zip 11236
V.,THIRD PARTY AIR MONITOR
17. Name Warren & PanziER EN 6 i S 18. Contact Person M I Cu rEL NO L A N
19. Federal Employer ID. # 1----------.-P-II -.-.-.-.-. , 20. Tel. # (212) 922-0077 Fax # (212) 922-0630
21. Address 228 East 45th St City New York State NY Zip 10017
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VL PROJECT INFORMATION
/ r
24. Starting date for this portion of work (s l t'I (O2 - Projected completion date -7 1 O 2~
Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 0 Thursday ❑ Friday ❑ Saturday ❑ Sunday
Shift from: ❑ am 0 pm to ❑ am ❑ pm 7 ~.
If other, S
RECENED .~
Access to inspect the premises must be provided daring are work schedule krddcated In this Item.
JUN 1 2 2002
25. Total amount of asbestos-containing material to be abated during this work ~P!BAn+H1.1
8 STOSiLE..
Square Feet, and/or 0 Unear Feet <s ,
PROGRAM
T G
2
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NYC-WTC 000128893
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