156 WILLIAM STREET; 1001281, 93/20

NYC 9/11 Public Portal Document

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

11358 DATE -? 4 5/ ' i

I. Job Site Address Owners name Wait and Load 156 Willi ns Suet Of Enwo Flute a In New York, N.Y. Time Out

I 2. Criltl~tpf,~a 5 & Drop Date

Ii48 Ralph Avenue c Brooklyn, NY 11236 E N E R 3. tion WDS phone number

A P.O. Boa 349 T O Scotland, Pa. 17254 Permit # 1009►34 R

4. Name and address responsible agency (Local, District or EPA Office where notification was sent)

US EPA 290 Broadway, New York 10007

S. Description of materials 6.VEH. LIC. # 7. TOTAL QUANTITY (RQ) WASTE ASBESTOS 9, NA2212, III TYPE • BAGS SIZE CUBIC YARDS 8. Generator Certification 7/ //c/A T 9. CONTRACTOR CERTIFICATION: 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. /l ( _ if y L S '^" ~ _~ , Printed/Typed Name Title Si nature Date P 10. Transporter #1 (Acknowledgement of receipt of materials) DEC Permit No. 0 IESI NY CORPORATION • 1 10 5th Street, Brooklyn; NY 1 S JA-462 R T DRIVER E Prin yped Na a Title si azure Date M ► R 1 l . Transporter #2 (Acknowledgement of receipt of materials) DEC PERMIT #

c \_ W A Printed/Typed Name Title si Dat /Y E 12. Dcrepancyindication space

S • I T 13. Waste disposaJ.site owner or operator: Certification of receipt of asbestos materials covered by this manifest except as noted in item #12 E

Printed/typed Name l Title kt} Sign. re Date (M/D/Y) ~4 .CZ.

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

NYC-WTC 000110697