Invoice for asbestos sample analysis, 44 Wall Street

NYC 9/11 Public Portal Document

3i

IESI NY,CORPORATION Oa 110 5th Street • Brooklyn, NY 11215 Phone: 718-522-2263 • Fai: 718-522-2697 MANIFEST U ` .i 4 A, a r !

DATE IA- qg 1. Job Site Address Owner's name wait and Load .,a•.$' ;r'a43 r s ' : rf4 ei i ~: 3 s 3 £:Y. `f fie In •, • Time Out 3

2. Contractor's name and address Drop Date

o E a s,• . ~.

E R 3. Waste disposal site (WDS) name, mailing address and physical site location WDS phone number

• O P.O ?~ .`.`

4. Name and address responsible agency (Local, District or EPA Office where notification was sent)

US EPA 290 Broadway, New York 10007

5. Description of materials 6.VEH. LIC. # 7. TOTAL QUANTITY (RQ) WASTE ASBESTOS 9, NA2212, III TYPE . " 7 BAGS SIZE .' CUBIC YARDS 8. Generator Certification pt a `'

T 9. CONTRACTOR CERTIFICATION: I hereby declare that the contents of this consignment are fully and agcutately described R above byproper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by A highway according to applicable international government regulations. A

S PrintediEylëd Name Title Signathre Date P O 10. i~ #1 (Acknowledgement of receipt of materials) Transporter DEC Pemut No. IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 1.1 J5 j J4 _ : '44 . T ai ", DRIVER 'J ~ ~ - "" =o ,, ` "' E Printedrryped Name Title Si 'attire Date M/D R 11. Transporter #2 (Acknowledgement of receipt of materials) {; DEC PERMIT # W

S Prinred!ryped Name Title Signature Date E 12. Discrepancy indication space

S I ' T 13. Waste disposal site owner or operator. Certification of receipt of asbestos materials covered by this manifest except as noted in item #12 E

Printed/Typed Name Title Signature • • Date (M/D/Y)

WHITE:LANDFILL • GREEN:IESI • PINK:GENERATOR • YELLOW:CONTRACTOR • GOLD:JOB SITE

NYC-WTC 000094962