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Permit application project monitor log for asbestos removal

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Application form for a permit covering an asbestos removal project with specified contractor and task details.

NYC-WTC_000177450–000177453
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NYC 9/11 Public Portal Document

QWTC PROJECT MONITOR LOG 4. Project #: 5. Work Area(s): Parti 1. Client; 2. Ptpject Name: . V FC 1___ 3. ProjectAdd^^ 4a. Task #: 22. 6. Contractor: 7. Contractor's Foreman: 8. ATC^epf^sentative: 9. Date:

Type of Project: Full-Containment Tent-Containment Glovebagging Other

Size of Proiect: Large (> 160 sq. ft., 260 lin. ft. of ACM) Small (< 160 sq. ft., 260 lin. ft.)

Phase of Abatement: Pre-abatement Sampling Prep Removal j;22rCleaning

Encapsulation Waste Load-out Finals

FULL-CONTAINMENT ABATEMENT

Work Area Location (floor, room, section):

Preparation of Work Area: Yes (Indicate prep work pei/ormed in 1 -10) N/A (If already completed)

1. Construction of Decon: Yes No 2. Ceiling Poly: Yes No 3. Critical Barriers (CBs): Yes No 4. Wall Poly: Yes No 5. Removal to establish CBs: Yes No 6. Floor Poly: Yes No 7. Negative air: Yes No 8. Pre-cleaning; ) Yes No 9. Prep work completed: Ye: No 10. Temporary Power: / Yes No 11. Other_______________ Yefe No 12. Prep-Inspection Passes: Yes No (Explain why)

Removal: Yas (Complete 1 - 5) N/A

1. Type of ACM: Pipe Insulatic^ Duct Insulation Fireproofing Ceiling Tile Boiler Insulafon Transite Boards FlooiTile Other:

2. Negative air pressure > 0.02 in. of wa er: Yes No 3. Amended water u^ed during removal: Yes No 4. Critical barriers intact for shift's duratit n: Yes No 5. Proper Decon procedures followed: Yes No

Cleaning: Yes (Complete 1 - 6) N/A

1.1 st Stage 2nd Stage\ 3ra 3rd Stage 2. 12/12-hour waiting period after 1st cleaning: 3. Removal of 1 st poly layer after 1 st clearing: Yes No 4. 4/12-hour wailing period after 2nd cleaning: Yes No 5. Removal of 2nd poly layer after 2nd cleahtojig: Yes No 6. 1/12-hour waiting period after 3rd cleaning: Yes No

TENT-CONTAINMENT ABATEMENT

Work Area Location (floor, room, section):

Preparation of Work Area: Yes (Indicate prep work performed in 1 - 6) N/A (If already completed)

1. Construction of Tent: Yes Io 2. Pre-cleaning: Yes No 3. Construction of Decon: Yes Io 4. Negative Air: Yes No N/A 5. Prep work completed: Yes Io 6. Pref-inspectiAn passes: Yes No

Removal: 1. Type of ACM: Pipe Insulaion Duct Insulatic n Fireproofing Ceiling Tile Boiler InsBlation Transite Boat Is Floor Tile Other: 2. Method or Removal: removal within tent ------ Gross , Glovebag removal within tent (check 3 through 8) (If Glovebag Removal Check 3 through 8) / 3. Glovebags smoke-tested: I Yes No 4. Glovebags attached to smooth surface: F Yes No 5. Amended water used: Yes No 6. Removal included cleaning and encapsulation: Yes No 7. Open/damaged ends of insul. sealed: Yes No 8. Glovebags vacuumed, double-bagged: Yes No

Continued on Back Form NY-8 1/01

CONFIDENTIAL, CITY_21MC100_003446222 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000177450

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NYC-WTC_000177450Source: NYC Law Department, mirrored locally

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