Permit application project monitor log for asbestos removal

NYC 9/11 Public Portal Document

tcmTc 1. Client: ASSOCIAIES INC

2. Project Name: PROJECT MONITOR LOG 3, Project Address: 4. Project #: 5. date: Part?

-r-C-- 4a. Task #: Ooo X- PREP-INSPKTION CHECKLIST: Work Area Location: Pass Fail N/A Pass Fail N/A

1. Vacated by occupants. 8, Openings <32fF covered by 2 lyrs poly.

2. Warning Signs (Eng, Sp). 9. Openings >32fF covered by plywood and two layers of poly. 3. Electricity down/locked out. 4. Power outside work with GFI. 5. HVAC off, locked-out, isolated, A t 10. Movable objects pre-cleaned, removed from area. 11. Fixed objects pre-cleaned, plasticized. or pressurized. 12. Floor poly 6" onto walls (12" = NYS). 6. DECONTAMINATION UNIT: 13. Wall poly to the floor. • Outside work area 14. 6" overlap between adjacent sheets • CIn, shwr, eqpt rooms of poly. • 2 layers. 6-mil wall poly I 15. Elevator bypasses work area. • 2 layers, 6-mil floor poly 16. Plywood/poly barrier before elevator • 1 shower per 6 workers doors. • Hot/cold water 17. Perimeter diaphragm for elevator barrier. • Waste water < 5 microns 18. 4 air changes per hour from negative • Waste water sewer/drum air unit. | • Soap/Shampoo 19. New filters in negative air units. • Disposable towels 20. Negative air pressure > 0.02 /

• Waste bags 21. Minimum 2 means of exiting work arsa. 7. POSTINGS: 22. Toilet for abatement personnel. I • Regulations 23. Waste Decon for >1,000 ft. ACM / (NYC, NYS, OSHA, EPA) 24. The following additional equipment) • Sign-in logs • 6-mil disposable bags with • Evacuation Plan warning labels • Supervisor's license • Poly and Duct Tape • Worker licenses • Fire extinguisher • ACP-7 • Approved respirator • Building Permit/Placard • Replacement filters • EPA 10-day notification • Protective Clothing • NYS Notification 25. Work area pre-cleaned • Emergency Numbers 26. Work area passes inspection Yes No • Material Data Sheets

PRE-ENCAPSULATION/FINAL INSPECTION CHECKLIST: Work Area Location:

Pass Fail N/A Pass Fail N/A

1. No visible debris on walls, floors. 8. No bags of waste in work arM. 2. No visible debris between decking 9. All equipment clean. \ and beams. 10. Neg. Air ^0 02 inch of water.', 3. No visible debris behind perimeter ■/ I columns. 11. Airless spray equipment used.

4. No visible debris on top of ducts. 12. Work area is dry, free of water ( ools.

5. No visible debris on hangers, rods, 13. The area suitable for encapsulation. lights, 14. The area suitable for final air clearance. 6. No visible debris on poly. 15. Work area passes inspection. Yes ___ No (Explain why) 7. No visible debris on pipes. Form NY-9 1/01

CONFIDENTIAL, CITY_21MC1OO_OO3446224 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000177452