Asbestos project notification form for NYC DEP

NYC 9/11 Public Portal Document 1<A1UUZ 04/25/2002 09:56 FAX 2129444618 ambient group

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY Asbestos Control Program Fee (if any) $ only u BSP)J 59-17 Junction Boulevard, S'* Floor. Corona. NY 11368-5117 Amendment2,^^i^^/_::;;^i^2^^^ TYPEWFilTTEN FORMS WILL BE ACCEPTED I. J ASBESTOS PROJECT AMENDMENT FORM FOR FORM ACP 7 Information Only: D Yes □N A modification Is valid only if it Is received by the NYCDEP prior to Ihe previously filed date of completion, except for start date changes that must be received by the origir al start date.

ACP7 TRU/BN# 0512MN02 Facility Address Liberty Street Borough Manhattan gp 10006

Date ACP7 was filed 4/16/02 Variance # (If any)

Was this ACP7 amended before? O Yes IE! No If yes, specify date

Original Start Date 4/24/02 Original Completion Date 7/31/02 from AGP 7, #24.

PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notiricalion may bo modified no more than twice. Only Ihe building owner may antend items IV and V. The original applloult or building owner may amend all other items. IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name __13. Conta si Person

14. Federal Employer ID. # 15. Tel. # Fax#

16. Address City State Zip

V. THIRD PARTY AIR MONITOR ? KCEIVED \ 17. Name j. M— i M—i— 18. Contact Person

19. Federal Employer ID. # j, 20. Tel. # Fax#

21. Address Cily_. State Zip

22. Sample Analysis Laboratory. 23. NYS DOH ELAP#

VI. PROJECT INFORMATION El Project Cancell 24. Starting date for this portion of work Projected completion date 0 Project Poslpoi

Asbestos work schedule d Monday D Tuesday d Wednesday d Thursday Q Friday O Saturday D Sunday

Shift from: 0 am O pm to EJ am n pm If other, specify.

25. Additional asbestos-containing material to be disturbed during this work ___ Square Feet, and/or Linear

Reduction in the amount of ACM to be disturbed during this work ____ Square Feat, and/or Linear F

29. Abatement Procedure for Additional Matenal (Check alt appropriate boxes) □ Full Containment n Glovebag □ Tent n DEP Variance Application

Other Changes

30. Locations of abatement modified by above (For each floor list ACM quantity and type)

31/32. Name of Applicant / Owner Tel.#

Name of Company (If any) . Fax#

Address City State .Zip

I hereby declare that the Information provided herein is true and complata^-^^ -------- 4/25/02 ;,V •Sionalure of AoDllcant /Owner rwZ

NYC-WTC_000154697