Asbestos Project Notification and Inspection Report, Dec 2002

NYC 9/11 Public Portal Document Fax:718-595-3525' * Dec 12 2002 11:47 P.03 DEP COMM. OFFICE P.03/03 ■ DEC-12-2002 11=40 administrative OPERATIONS r'*'' A»Htb~ro3 INSPECTION REPORT (continued) <1, ‘ a ___ Tel# 26. Asbestos Hauler OSS Abatement, inc. NYS DEC Permit tf. 1 i Disposal Sitefa) - -------- - ---------------------------------- ---------------- I I z. Ths asbestos abatement is part of a (item a through e requires Filing of this farm with NYC Department of Buildings) 8) D Demaliliofi b) Q Bpiier Rjeplacemen! e) d Sprinkler Repiacemoni d) 0 Renovation/AKeratron

et n Fireproofing Replacement 0 Q Other (Describe)

2fi. TYPE OF ABATEMENT (Check all appropriate taws) 0 Removal Q Endosure D Eneapsmailen n Repair D Clean jp

29 ABATEMENT PROCEDURE (Check all approphate boxes) 0 Full ContsinmanI 0 Glovebag 0 Teni 0 DEP Variance Application

30. LOCATIONS OF ABATEMENT describe section AFFECTED SURFACES AMOUNT OF ACM JESCRiPTION OF WORK BEING F)Oor{K) OF FLOOR CONTAINING ACM PERFORMED (eg entire.eaalw,rig.reatnU. (O B Pip* bgsing. cnling. ptonum bquaae LII*£AR (c-g. /ynnins cMtc. irMljilinj Bf» spnnWBPj. baiiBf recm, tabby, ale] duets. rtBHniEi»wlis, Feer mwFvuw ana maaewa baiwf». gvi.l Room # 4,A. 450^ RenovatiDn Bsmt' Floor Tiles Pipe Insulation 18 Renovation

I

1

31. I hereby dedare that the information provided herein is true and complete Io the best of my Knowledge. I am familiar with Federal State and n*c laws and regulations applicable to asbestos related work. I KAM Consulate DAS Abafemenl, Inc*. Knushru Hava < ------- ----- _ w I PHniNarrwc/AirMoftitBr ' Prini Name rf AabMioe O«"ir»cior P»Ml Mame d A^em ill iKar Owvc)

SISnaNra SlgRWura sigftauir*

12/10/02 12/10/02 12/10/02 53!" Pan

TL I understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for ths performance of (he asbestos abatement activities in accordance with the Asbestos Control Program Rules t have arntraeted (ha third party air monitor wta is completely independent of all parties inwotved in the asbestos project I hereby declare Iha! | have authorized the filing of this notifioatjon for the work specified herein. Pario Vasquez, City of New Tone, OCAS 12/10/02 erifli Name al Owner Stgruiura aai A STAMPED COPT OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

nation provided en (hla term must be reported immediately in writmfl directly to the FfTC PEP ACP, । ............ .................. -........... -............. - ......... .. .....................

TOTAL P.03

NYC-WTC_000149466