NYC 9/11 Public Portal Document
31744
TSrI TRI-STATE TRANSFFT
1199 Randall Avenue
Bronx, New York 10 .,4
.00., INC.
718/ 617-0771 - Fax: 718/ 378-5858
MANIFEST NO.
JBT. NY DEC 1A375
NJ DEP SW1896
DATE 09-2P-2002
NON - HAZARDOUS WASTE MANIFEST
D.B.C. IA-375
nRr2A-4SII
FRIABLE AT POINT OF ORIGIN DOUBLE BAGGED AND MADE NON-FRIABLE FOR HANDLING AND TRANSPORTATION.
(FRIABLEASBESTOS ONLY)ASBESTOS,9.NA2212.111.RQ DEP WASTE TYPE ID27A
USEPA AIR COMPLIANCE BRANCH. REGION 11 290 BROADWAY NEW YORK NY 10007 212-637.4249
120 LIBERTY LLC 99-77 QUEENS BLVD. FLUSHING NY 11374 (516)781-3000
BUILDING OWNER'S NAME AND MAILING ADDRESS PHONE NO
125 CEDAR STREET NEW YORK NY
SITE OF GENERATION (lt d1IIiereflt from alamag a Wess) DEPT. NO.
J.B.T DEC#1A-375 OR TRI-STATE TRANSFER ASSOC. INC DEC#2A-4561199 RANDALL AVENUE BRONX, NY 10474
ASBESTOS HAULERS COMPANY N
TRI-STATE TRANSFER ASSOC. INC. -600x1-00006/1_1195 RANDALL AVE. BROAD NY _10474_71 -617-O77
TRANSFER STATION DISPOSAL FACILITY PERMIT NO. (11 digits) ADDRESS PHONE #
BFI IMPERIAL LANDFILL 11 BOGGS ROAD. P.O. BOX 47 IMPERIAL, PA 15126 -695-090 100620
DESIGNATED DISPOSAL FACILITY NAME. SITE ADDRESS, TELEPH E NO.. gt PERMIT NO.
ROLL-OFF (1) 40 CYDS TRL 40 CYDS TRL
TYPE OF CONTAINERS NO. OF CONTAINERS UNITS (WT. /VOL) QUANTITY
FIBER CONTROL INC.
ABATEMENT COMPANY NAME
3010 BURNS AVENUE WANTAGH NY 11793 (516)781-3000
ABATEMENT COMPANY ADDRESS PHONE NO.
PROGRAM MANAGER'S NAME PROGRAM MANAGER'S AFFILIATION
pn
BUILDING OWNERS CERTIFICATION: I CERTIFY THAT THE ABOVE DESCRIBED WASTE CONTAININGASBESTOS IS
FULLY AND ACCURATELY DESCRIBED AND HAS BEEN THOROUGHLY WET DOWN. PACKED AND LABELED IN
FULL COMPLIANCE WITH THE PROVISIONS OF SECTION 16-117.1 OF THE ADMINISTRATIVE CODE OF THE CITY
OF NEW YORK AS AMENDED BY LOCAL LAW 21 OF 1987. O' 9 % T
U154Hlil'l K - 1NU1l 06H SMALL
/
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(;
DESIGNATED DISPOSAL FACILITY'S OWNER OR OPERATOR CERTIFICATION OF RECEIPT OF WASTE COVERED
BY THIS MANIFEST, EXCEPT AS NOTED IN THE DISCREPANCY INDICATION SPACE
TST COPY
NYC-WTC 000108280
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