NYC 9/11 Public Portal Document
y . ~
Emergency Contact Telephone Number
I. Generator's US EPA ID No. Manifest 2. Page 1 Information In the areas Is
UNIFORM HAZARDOU Document Na. o ,r rep by Faders 1".
WASTE MANIFEST . . . . . i ^.y
3. Generator's Name and Mailing Address r' _..1..■ ' • A. State ManhfestOooumentNumber
..,,' f1:`.2 :c t.^ € f=iEt1
NEW YORK NY B State: eetsrators lD
4. Generator's Phone ( )
5. Transporter 1 Company f 6. US EPA ID Number Jo.::.0mW-1rappporutr' ._
;
A ct it n
j
' U k. lY . i.'t t f~ -~~y~4
- {iM,, $ iJ ~ ~ ~# ~f `~• ~1 ~ ill! 4 p.~.T8spni3 8P
, . . 1`.. ' ;=:
7. Transporter 2 Company Name 8. US EPA ID Number f ;„ Y# IMF
c d tt i P his tin h x, 41 V 4 7 4 43 0 4 F TMnapartiet"s Phone ( 1G) —
9. Designated Facility Name and Site Address 10. US EPA ID Number -(: 'State ID
{ a ijx.y
Fa011lty'e} .. . . .. .
c hcwlw i WY.r.iAe T:i h i t. ..:
t .
42-'14 19TH ' W 6riu s H. FaciUts Phone.
tsIont INl°( 41 V 7 - 4442€_ = (718) 74-333
11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Nu nber) 12. Containers 13. 14.
Total Unit I.
No. T Quantity Wt/VoI WastedN-
a, ante y Paint t' aced h terra 5 3 4
;N2&.3. PG TI (spent inners/t3airrts)
G b.
E
N
R
A C.
T
0
d.
... .
Additional Descriitoc1 01S aefal li edJ fC!#":'%'`; "u`:"::: 1{''Handngodes for Wastes tistad ova
'
a.Oil P t'l 'I"h t1t'tilEt" ~;;#~::
~. Sir •
15. Special Handling Instructions and Additional Information
~. (atid' 1 codes)
16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name are classified,
packed, marked, and labeled, and are in all respects In proper condition for transport by highway according to applicable international and national governmental regul4tions.
If I am a large quantity generator. I certify that I have a program In place to reduce the volume and toxicity of waste generated to the degree I have determined to economically
practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat human health
and the environment; OR, If i am a smell quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste manageme method that Is
available to me and that I can afford.
Pri Name ! Sigrxtrt Day Year
f
T 17. Transporter 1 Acknowledgement of Receipt of Materials
N Mon Day Year
___
Pd
8
O 18. T f of Materials '
P Sig - • Mon Day Year
19. Discrepancy Indication Space
F
A
C
I
L 20. Facility Owner or Operator. Certification of rec 1pt of hazardous materials covered/ by this manifest except as noted
T t
In Item 19.
Y yped ,N Mod Dad Year
nt
ry ,
II1 d a .1
' (,44) } :
•
r
TRANSPORTER #1
NYC-WTC 000108044
OCR can misread numbers and units. Confirm readings against the page image before using them.