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Asbestos project notification form, 100 Church Street

Machine-extracted title · confidence 50%

Application form submitted to DEP for an asbestos inspection or abatement project at 100 Church Street.

NYC-WTC_000154727–000154730

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 1

PROTEi

a(d^DapL<IBUNa FOR OFFICJALU^ ONLY . ONC V^ATIO, 1. $1 2nn An ACCEPTED • (isMfeasehwiula) When submitting this for ’QQh^^C p^rtmant otBullcHngsTil^ original form and three (3) copies with original signatures are reffiiired. Submittal attho-NYCOEn rsqutres one copy of!^ form with original signatures. This form must ba submitted to the NYC DEP not less than one week In advance^of the start of abatement activifies.

I. FACILITY

2. Address 100 Church Street Borough Manhattan Zip 1 nnn? AKA 3.BIockJ 2^ 4. Lot 20 5. Type of Facility_________ ___________________ 6. Name of Building II. BUILDING OWNER 7.Mama 90 Church^ LLC. Zar Realty 8. Contact PersorMa 1 Ini

9.Tel.# (212)971-0111 Fax# (21

10. Address ^84 Fifth Avenue atv New York State NY Zip lOnift

nt. GENERAL CONTRACTOR 11. Name, Tel.#

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name 192 Branch Interior Services. Inc. 13. Contact Person Chris Saliani 14. Federal Employer ID. # Pll 15.Tel.# (631 )563-730Q Fax# (631 )56.3-73flQ 16.Address '101-2 Colin Drive CityHolbrook State NY Zip11741

V. THIRD PARTY AIR MONITOR

17. Name Ambient Air 18. Contact Person Peter Shork 19. Federal Employer IO. # Pll 20.Tel.# (212) 944-4615 Fax# (631 )563-7389 21. Address 55 West 39th Street_____ City New York_________ State NY Zip 22. Sample Analysis Laboratory Ambient Air 23. NYS DOH ELAP# 10865

VI. PROJECT INFORMATION 24. Starting date for this portion of work 11/14/01 Projected completion date 1 2/07/01

Monday Q^uesday 0 WednesdayThursday 13 Friday^ Asbestos work schedule AOI Shift from: ?J^0 d pm to Q * 00 d am 0 pm

If Other, Receweo specify------------------------------- - ------------------------------------------------------- ---------- —- NOV 3 0 2001 Access to Inspect the premises must be provided during the work schedule indicated in this item. r'

25. Total amount of asbestos-containing material to be abated during this work ^9 79^50 0 gqyg^Q pgg{, and/or 0 Linear Feet ACP7 2«001

NYC-WTC_000154727

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NYC-WTC_000154727Source: NYC Law Department, mirrored locally

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