NYC-WTC_000196105

NYC 9/11 Public Portal Document

FROM : SEAY YARBROUGH INC PHONE NC. : 2120689293 Apr. 18 2002 10:39RM P2

ONLYTYPEWRinEN DEPARTMENT OF ENVIRONMENTAL PROTECTION Page i o< AW1JCATIQNSWH.L MACCEPTED P NOT AN ASBESTOS PROJECT | fOW Offset ?<JMOS£S C«Y 1. NOTE: THIS FORM IS TO BE COMPLETED IF THERE IS NO FRIABLE ASBESTOS CONTAINING MATERIAL WYC Laarg* O»w- PRESENT OR IF THE TOTAL AMOUNT OF PR ABLE ASBESTOS CONTAINING MATERIAL IS 10 SQUARE FEET OR LESS, OR 28 LINEAR FEET OR LESS, OR IF NORMALLY NONFRIABLE ACM (AS PER 40 CFR ACP5Fee$ PARTBi 141)IS PRESENT IN ANY AMOUNT. wre tee- al WMiawiwel Paarte

2. FACILITY ADDRESS Broaduay BORO tonhattan qqq£ 10038

3. BLOCK#—70 1 16 AKA _ 4. LOT A

8. BUIU3IHG nvuMPR TtS NYC Real Estate LLC ) 563 7440 tel.#l£1 S.AOQMSS 560 Sth Avenue STATE- A-L 10036 7. CONTACT PERSON Triiparchi a TEL #(2^2 1^63 7440

g.EMSCWPriON OF ENTIRE SCOPE Of WORK fto tork

10. ESTIMATED START DATE. n/a ESTIMATED completion PATP OF THE ENTIRE SCOPE OF WORK.

11 I .. HAVE CONOUCTED AN ASBESTOS INVESTIGATION ON ACCORDANCE WITH THE . ttoeo moi H PROGCOUAeS REQUIRED SV THE NYC OEP ASBESTOS CONTROL PROGRAM REGULATIONS ANO DECLARE THAT AT SAID FACILITY address, THE □ A pfwnaea Io be UwnoiMhed are free of any asbestos containiiig matterill (ACM) □ b. premises lobedomoliStiecf contain 10 aquare feet or less or 2S linear feet or less of triable ACM or of normally nortfriable ACM that demolition forooe may make fiiable: al ACM shall be ramoved according Io the NYS DOL ICR 56 or the NYC OEP Aifaestos Hegutebona Qe. cumotate/e surfaces of relevant airuclure(s' affected by an alteration or plumbing repair are free of any friable ACM and tree of normalty nonfrlable ACM that alteration or plumbing repair loroes msy make friable Q d. cumutartive aurfacee of relevani structure(s) atleoted by an alteration or piumbing repair contain 10 aquare feel or leas or 25 linear Hat or lets ot'UabH ACM or of noimally nonfriahJe ACM that akeraboa or plumhing repair forces may make friable; removal as in b. Qe. nomialty nbnfrtoble ^*^g**)^*^| i^sturfyd/renioved in accordance with the NYS DOL ICR 56 or the NYC OEP Asbestos

'■ Of. fnsbis ACM and/or normally norVriabie ACM win NOT be disturbed during alteralion/plunibing repair/modificalion/renovstion. FriaCie ACM Sq FI Un Ft Morlriabte ACM Sq Ft 12. 1COMPLETE ANC THOROUGH ASacSTOS INVESTIGATION PERFORMED OF

STonr DcscniK secnoM OF njoo# AU fRUaLE SURFACgiG MATERMS HUmER ASaems pHtuesauar fag. snUM, sial wing roen I.___ MCLUCHNO FRIAILIACMANO OFCAMPUet sadbaamM SeaKiaaa.iabey.tlc.j eoneAuyNOMnuABUACe AHAUtZEB iETTl JS. toof Entire Chrysotile ACM IK 2 X Ird Floor Entire None 8 X tnd Floor Entire None 5 X 1st; Fl oor Entire None 5 X Cellar Entire None 7 X Sub Cellar Entire None 5 X

13- NAME OF LABORATORY THAT ANALYZED SAMPLES Scientific lafxiratorlBs .Inc.

1 <- ELAP # ____________ tot Applicable.. / NVt OCRT. OF HEALTH OtRTinCAl ION uA0MFro^rorti<i<cfe.w.us7 15. DATE(S) SAMPLES ANALYZED ^3/2002 OF THE ANO THAT TRE INFOI 16. PROVIDED HEREIN IS TRUE ANO COMPLETE • 'xtactrot iNweSTMATOn 4/15/2002 CUTE NYCOEP/Z CERTIFIEO' s 17.# 1772 NYC.aiFaatatTOSMUlSTiaaTOnCSnTl>ICAfeNUM» AsaesTosX NOTE; STOrUOe, TRANSPORTATl.ON AND DISPOSAL OF ASBESTOS CONTAMINATED . WASTES ARE REQULATK) BY THE NYC DEPARTMENT OF SANITATION 1J.7»6S1 INVESTlGATOfl THE PICCGMCAU CARRYING OUT OF AN OPERATION TO AVOID COVERAGE BY A STANOARO THAT APPUBS ONLY TO OPQIATtOMS UUMCR THAN A »FSCtF«O StZE IS A VIOLATION. ACM - Asbestos Gora*,Ting Maurial . MatanaJ Containing Greater than 1% Asbestos

ANY MODIFICATION OR VARIANCE FROM1NFORMATION PROVIDED ON THIS FORM MUST BE REPORTED IMMCOIATELY IN WRITING DIRECTLY TO TME NYC OEMRTMENT OF ENVIRONMENTAL PROTECTION ASBESTOS CONTROL PROGRAM .' NYC OCPT. OF ENVIRONMENTAL PROTECTION. M-17 JUNCTION BLVD. - 8th FLOOR, ELMHURST. NEW YORK 11373-8107

FOfMACPS

CITY_21MC100_011098518

NYC-WTC_000196105