EPA residential dust cleanup request form, 2002

NYC 9/11 Public Portal Document

' EPA Dust Cleanup: Request Form https://nyrpub.epa. gov/NYRDUST2/dustcleanup/building.html

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Lower Manhattan Dust Cleanup 'Whole Building' Request Form This form is for use by building owners/managers, co-op boards and/or tenant association (TA) representatives who are coordinating building-wide cleanups in the lower Manhattan dust cleanup area (south of Canal, Allen and Pike Streets). Please note: Residents of buildings seeking to coordinate cleaning activities must still make individual application for assistance.

ZIP Code (required): Note: To be eligible, you must reside In ZIP codes 10004, 10005, 10006, 10007, 10038, 10280 or the portions of ZIP codes 10002 and 10013 that are south of Canal, Allen and Pike Streets. Requestor (required): Your Name Building (required): Building Street Address Zkssociation Name: Tenant Association name (if applicable)

I Owner Position (required): Other:

Telephone, Daytime (required): Telephone, Evening: Telephone, Cell: Email: Number of units (total): Number of units participating: All Units: YesNo'/" Request coordinated Most Units: YesT No^ cleaning/testing of: Common Areas: Yes No C Request evaluation of HVAC: Tno Security Code (required):

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NYC-VVTC_000141037