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WTC debris inspection form, 86 Nassau Street

Machine-extracted title · confidence 95%

Form documenting facade conditions and ACM presence for a building at 86 Nassau Street.

NYC-WTC_000099325–000099339

Folder label: “86 NASSAU STREET 1001202, 78/40

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Scanned page image, NYC-WTC_000099327
OCR text

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NYC 9/11 Public Portal Document

to' . : s

S 9 IESI NY CORPORATION 110 5th Street • Brooklyn, NY 11215 Phone: 718-522-2263 • Fax: 718-522-2697 MANIFEST

11495 DATE 7 (277"~~- L J,;h Site Address Owner's name Wait and Load 8iar' 1w,-Ia9t1 3S,~1':ird Dept Of EnvirO Prc,te . me In N air Yo,•= c, .A'r- t. Time Out

2. c Cx Drop Date c3 t 3a #t & fl E24 9 Ralph Avenue E N E R 3. W pb tin !' ae i i t4 cation WDS phone number A F0. Box 399 T Kr+C41thutLt. Pa. °.5.1 Petniit O R

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 ' .- : ' ' BAGS SIZE JL>>',- ~. CUBIC YARDS g. Generator Certification

T 9. C ON T RA CTOR C E R T I F [CAT I O'. I hereby declare that the contents of this consignment are fully and accutately described R above by proper 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. /. N i .. 11t Z y I I" c. 2 S Printed/Typed Name Title Si nature Date (M/Dl~r a P 10. Transporter #1 (Aaknowledgemeet of receipt of materials) Permit No. O IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 11215 JA-462

T / fif'Jt/YL.. -DR E Printed/fyped Name Title ' Signature Date M/D/Y 1 1ST R 11. Transporter #2 (Acknowledgement of receipt of materials) DEC PERMIT # W A Printed/Typed Name Title `gi ature Date(M/DN) 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

Printed/Typed Name k : .. . Title irff. t ( ~f td ..~,(y +i'Y ; Sigtiafure" 1 • Date (M/D/Y)

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

NYC-WTC 000099327

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NYC-WTC_000099327Source: NYC Law Department, mirrored locally

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