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Permit application project monitor log for asbestos abatement phase

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Application form for a permit covering the pre-abatement or removal phase of an asbestos abatement project.

NYC-WTC_000177466–000177469
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NYC 9/11 Public Portal Document

PROJECT MONITOR LOG Part 2

2. Project Name: 3 Project Address 4. Project 5, Date:

.J _________ -4U- PREP-INSMCnON CHECKLIST: Work Area Location: Pan Fail H/A Paa Eail H/A 1. Vacated by occupants. 8. Openings <32fF covered by 2 lyrs poly. 2. Warning Signs (Eng. Sp). 9. Openings >32ft’ covered by plywood 3. Electricity down/locked out. and two layers of poly. 10. Movable objects pre-cleaned, removed 4. Power outside work area with GFI. from area. 5. HVAC off, locked-out, isolated, 11. Fixed objects pre-cleaned, plasticized. or pressurized. 6. DECONTAMINATION UNIT: 12. Floor poly 6" onio walls (12”«NYS). 13. Wall poly to the floor. • Outside work area • cm, shwr, eqpt rooms 14. 6" overlap between adjacent sheets of poly. • 2 layers, 6-mil wall poly 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 • Waste water < 5 microns barrier. • Waste water sewer/drum 18. 4 air changes per hour from negative 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 area. POSTINGS: 22. Toilet for abatement personnel. • Regulations (NYC, NYS, OSHA, EPA) 23. Waste Decon for >1,000 ft. ACM • Sign-in logs 24. The following additional equipment: • Evacuation Plan • 6-mil disposable bags with 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: Em Elil N/A Em Eli! M/A 1. No visible debris on walls, floors. 8. No bags Of waste in work area. 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 columns. 11. Airless spray equipment used. 4. No visible debris on top of ducts. 12 Work area is dry, free of water pools. 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.

CONFIDENTIAL, CITY_21MC1OO_OO3446318 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000177468

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NYC-WTC_000177468Source: NYC Law Department, mirrored locally

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