Asbestos project notification and inspection report form

NYC 9/11 Public Portal Document

cm~ oinyp,.,~ NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard. 8th Floor, Corona, NY 11368-5107 ~K T .`~ Buidii or TRU No TYPEWRITTEN , j FOR .USE ONLY FORMS WILL BE °&3!°. °. ASBESTOS PROJECT NOTIFICATION L ACCEPTED (ASBESTOS INSPECTION REPORT) 1.~ (See fee schedule) 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 must be submitted to the NYC DEP not less than one week form with original signatures. This in advance of the start of abatement activities. I. FACILITY

2. Address 150 Franklin Street Borough Manhattan Z;p10013 AKA WTC Indoor Dust lainglain Program 3. Block 4. Lot 5. Type of FacilityResidential Apartments g, Name of Building II. BUILDING OWNER

7. Name Emily Sorkin 8. Contact Person _ Emily Sorkin 9. Tel, # 212-941-7858 Fax# 10. Address 150 Franklin Str,J P11 City NY State N Zip 10 01 3 III. GENERAL CONTRACTOR

11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR 12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan 14. Federal Employer l D. P!1 15. Tel. # 718-961-4100 Fax # 718 - 9 61- 410 3 16. Address 14-20 129th Street City ge Point stateN3~.__ Zip V. THIRD PARTY AIR MONITOR

17. Name AT C Associates Inc. _18. Contact Person Fred Burkhardt 19. Federal Employer 1D. #L _ P11 20. Tel. # 212-353-8280 Fax# 212-353-8306 21. Address 104 East 25th Street C; ~' NY State.JL Zip 10 010 22. Sample Analysis Laboratory EMSL 23. NYS OOH FLAP #11506 VI. PROJECT INFORMATION 24. Starting date for this portion of work 1 / 2 2 / 03 Projected completion date J122 2 / 03 Asbestos work schedule ❑ Monday ❑ Tuesday ® Wednesday ❑ Th ursday ❑ Friday 0 Saturday Sunday Shift from: 8 ®am ❑pm to 4 4 Dam ®pm If other, specify

Access to inspect the premises must be provided during the work schedule indicated in this item.

25. Total amount of asbestos-containing material to be abated during this work 121 Square Feet, and/or Linear Feet

ACP 7 212001

NYC-WTC 000129016