Asbestos inspection form, 30 Wall Street, Oct 2001

NYC 9/11 Public Portal Document

37 . NYDEC 1A-371 NYDCA 483056

C beo aisporLaLion ~., Inc. P.O. BOX 1044 TOLL FREE PHONE 631-924-5050 HAMPTON BAYS, N.Y. 11946 1-800-755-OATC FAX 631-924-5085 "EMERGENCY NUMBER"

Waste Manifest # Job # Floor or Location Cust• # -.

1. Work ite Name and Mailing Address Owner's Narr14, ~ii; _: PYNE o A 30 WALL ST 30 WALL ST.

YEW OR N. . . NEW YO R . N.Y. Contractor's Name, Address Waste Disposal Site RI ') __20 NfEADOWFILL L;\NDFI—L 2 jTH ,. I ~_. . BOX 6 S RT . =" COLLEGE POINT N1 — BRIDGEPORT. WV. 26330 Name and Address of Responsible NESHAPS Agency Other ❑

U.S. EPA REGION II, 290 BROADWAY, NEW YORK, NY 10007 Description of Materials Bags - Cubic Y RQ Waste Asbestos, Class 9, NA2212, PGIII O Other Drums or Tons O _. E _ 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.

A-ni '-c' Printed/Typed Name — c itle X ignature A 1 - g/L Date (MI D/YY Transporter 1 (Acknowledgement of Receipt of Materials) Company Name and Address Signature: Telephone No. ASBESTOS TRANSPORTATION CO., INC. 631-924-5050 P.O. BOX 1044 Printed Name: Date HAMPTON BAYS, NY 11946 Title: DRIV Transporter 2 (Acknowledgement of Receipt of Materials) Company Name 'and Address Telephone No. Si ure 631-924-5050 ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 . Printed Name: • D to HAMPTON BAYS, NY 11946 Title: DRIVER Li U (o d Discrepancy Indication Space:

Waste pisposal Site Owner or Operator's rtification (Receipt of Above Waste Accepted) Telephone No. MEADOWFILL LANDFILL Signature: ! 1 3041 Su' —._1 t Date Printed Name: DI Company Name and Address Title: ~. ' 7 Z t- d

NYC-WTC 000112357