WTC debris inspection form, 53 Nassau Street, 2002

NYC 9/11 Public Portal Document

NYDEC 1A-371 37 NYDCA 483056 be~to~ CVr~nsporLation , Inc. P.O. BOX 1044 TOLL FREE PHONE 631-924-5050 HAMPTON BAYS, N.Y. 11946 1-800-755-OATC FAX 631-924-5055 "EMERGENCY NUMBER"

Waste Manifest # Job # Floor or Location Cust # 22

1 Work Site Name and Mailing Address Owner's Name, Address, Phone Number C. TUR': REALITY INC. 53 SA ST. 53 NASSAU ST. NEW YORK. N.Y. N.Y. . N.Y. Contractor's Name, Address Waste Disposal Site T . RiC ME T A ilW: _ ... .. AND _ I.... I- -23 _29.':'. STREET RT. -2. BO`: 6 t.'OL1.EGI. POI\T. NY BRIDGEPORT. WV. 2F.330 Name and Address of Responsible NESHAPS Agency Other 0

U.S. EPA REGION 11, 290 BROADWAY, NEW YORK, NY 10007 Description of Materials IBags - Cubic 1(ds. - Q Waste Asbestos, Class 9, NA2212, PGIII 0 Other Drams or Tons - OTHER`- 0 RQ Waste White Asbestos, Class 9, UN2590, PGIII Special Handling Instructions and Additional Information

OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked and labeled and are In all respects In proper condition for transport by highway according to applicable International government regulations.

rintedlTyped Name a lA Sure ate (M/DD/YY) Transporter 1 (Acknowledgement of Receipt of Materials) Company Name and Address Telephone No. Signature: 631-924-5050 ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 Printed Name: Date HAMPTON BAYS, NY 11946 'L j if Title: RIV R &TL Transporter 2 (Acknowledgement of Receipt of Materials) Company Name and Address — Telephone No. Si re: 631-924-5050 ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 Printed Name: c D HAMPTON BAYS, NY 11946 Tide: DRIVER Discrepancy Indication Space:

Waste Disposal Site Owner or Operator's Certification (Receipt of Above Waste Accepted) Telephone No. `E.3DOWF I LL LANDF i LL Signature: 304 2_2' i Printed Name: Date

Company Name and Address Title: SK

NYC-WTC 000099562