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Asbestos project notification form for NYC DEP

Machine-extracted title · confidence 95%

Application form submitted to the Department of Environmental Protection for notification of an asbestos inspection project.

NYC-WTC_000154680–000154700

Folder label: “Buildings 105 Duane 80 John Gateway etc. 75 Park 200 Rector Trinity Church

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NYC 9/11 Public Portal Document

FAL PROTECTION - Asbestos Control Program 59-17 Junction Boulevard, 8“’ Floor, Corona, NY 11368-5107

(wp; ASBESTOS PROJECT NOTIFICATION Building Dept or TRU No FOR OFFICIAL USE ONLY

(ASBESTOS INSPECTION REPORT) 1. «aBS=B=- icccpfipS , — nzh- www|ny^.i^»/tlep') (See fee schedule)

>When rmfting this form at the NYC Department of Buildings, the original form and three (3) copies with original >signpfi /are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This be submitted to the NYC DEP not less than one week in advance of the start of abatement activities .

2. Address 130 Liberty Street Borough Manhattan Zip 10006

AKA _3. Block _____ 4. Lot _J_

5. Type of Facility Commercial _____6. Name of Building

II. BUILDING OWNER

7. Name Cushman & Wakefield a/a/f Deutsche Bank 8. Contact Person Marino Prodan

9.Tel.# (212)618-3902 Fax# (312) 618-2208

10. Address 14 Wall Street City New York State NY zip 10005

III. GENERAL CONTRACTOR

11. Name Tishman Construction Tel # (212)399-3600

IV. ASBESTOS ABATEMENT CONTRACTOR 12; Name PAL Environmental Safety Cor^ 13. Contact Person P^ul Mast

14. Federal Employer ID. Pll 15.Tel.# (718) 349-0900 Fax#„(718)J49-2800

16. Address 43-09 Vernon Boulevard City Long Island City State NY zip 11101

V. THIRD PARTY AIR MONITOR

17. Name Ambient Group, Inc. 18. Contact Person Jo^n Leitner

19. Federal Employer ID. #t---------- Pll 20. Tel.# (212)944-4615 Fax# (212)944-4618

21. Address 35 West 39th Street Citv New York state NY 10018

22. Sample Analysis Laboratory Ambient Group, Inc. 23. NYS DOH ELAP # 11732

VI. PROJECT INFORMATION 24. Starting date for this portion of work _4/^/02 Projected completion date 7/31/02

Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 0 Thursday 0 Friday 0 Saturday 0 Sunday

Shift from: 8 0 am 0 pm to 0 am 0 pm 1111 if other, specify 1 Access to inspect the premises must be provided during the work schedule indicated in this item. ^PR * V. 25. Total amount of asbestos-containing material to be abated during this vizork ''A/ 1.

103.000 Square Feet, and/or 0 Linear Feet

Al 2/:

NYC-WTC_000154680

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NYC-WTC_000154680Source: NYC Law Department, mirrored locally

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