EPA Region II memo regarding WTC residential cleaning, July 2002

NYC 9/11 Public Portal Document

JUN-2110: lb

REQUEST FORM FOR INDOOR AIR RESIDENTIAL ASSISTANCE PROGRAM

Name of Resident

Address

Apartment Number:

New York, New York

Telephone Numbers: Home

Work

REQUEST Initial one of the following:

I request dust cleaning of the residence identified above (“Residence”) and monitoring afterwards to confirm that asbestos is not present above cleanup levels.

OR

I request monitoring of the Residence.

Initial one of the following:

I request “aggressive” air sampling, as described below.

OR

I request “modified aggressive” air sampling, as described below.

AGREEMENT In consideration of the benefits of the Indoor Air Residential Assistance Program, on behalf of myself and any other occupants of the Residence, I agree to the following:

I consent to employees and authorized representatives of the United States Environmental Protection Agency (“EPA”) and the New York City Department of Environmental Protection (“NYCDEP”) and contractors for NYCDEP having access to the Residence and the personal property in the Residence, as necessary, to conduct dust cleaning and monitoring activities. I understand that these activities are to be performed in accordance with the roles of EPA and NYCDEP under the Federal Response Plan and the authority of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. § 5121 ^.seg,

NYC-WTC_000154140