NYC 9/11 Public Portal Document
j MANIFEST NO. 31476
T TRI-STATE TRANSFER ASSOC., INC.
1199 Randall Avenue
Bronx, New York 10474
718/ 617-0771 - Fax: 718/ 378-5858
JBT. NY DEC 1A375
NJ DEP SW1896
NON - HAZARDOUS WASTE MANIFEST DATE 9-15-2002
D.E.C. IA-375
D.EC.2A-456
FRIABLE AT POINT OF ORIGIN. DOUBLE BAGGED AND MADE NON-FRIABLE FOR HANDLING AND TRANSPORTATION.
(FRIABLE ASBESTOS ONLY)ASBESTOS ,9,NA2212.111,RQ DEP WASTE TYPE ID27A
USEPA AIR COMPLIANCE BRANCH. REGION 11 290 BROADWAY NEW YORK, NY 10007 212-637x4249
120 LIBERTY LLC 97-77 QUEENS BLVD. FLUSHING NY 11374 (516)781-3000
BUILDING OWNER'S NAME AND MAILING ADDRESS PHONE NO
NYC-DEP 125 CEDAR STREET NEW YORK NY
SITE OF GENERATION (if differert from mailing address) DEPT. NO.
J.B.T DEC#1A-375 OR TRI-STATE TRANSER ASSOC. INC DEC#2A-4561199 RANDALL AVENUE BRONX, NY 10474
ASBESTOS HAULERS COMPANY N
TRI-STATE TRANSFER ASSOC. INC. 2-6007-00006/1 1199 RANDALL AVE. BRONX, NY _10474_718-617-(Y771
TRANSFER STATION DISPOSAL FACILITY PERMIT NO. (11 digits) ADDRESS PHONE #
B?! IMPERIAL LANDFILL 11 BOGUS ROAD. P.O. BOX 47 IMPERIAL, PA 15126 (724-695-0900) 100620
DESIGNATED DISPOSAL FACILITY NAME, SITE ADDRESS, TELEPHONE NO., & 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
A
BUILDING OWNER'S CERTIFICATION: I CERTIFY THAT THE ABOVE DESCRIBED WASTE CONTAINING ASBESTOS 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 0!8THE CITY
OF NEW YORK AS AMENDED BY LOCAL LAW 21 OF 1987. I fi
TRUCK LICENSE AB 7
#2 ACKNOWLEDGEMENT OF RECEIPT QF MATERIAL AS DESCRIBED ABOVE
11yIIin.,- G_. .7,hn 1O/CA a O_11-07
M
DESIGNATED DISPOSAL FACILITY'S OWNER OR OPERATOR CERTIFICATION OF RECEIPT OF WASTE COVERED
BY THIS MANIFEST, EXCEPT AS NOTED IN THE DISCREPANCY INDICATION SPACE
1ST COPY
NYC-WTC 000108273
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