NYC 9/11 Public Portal Document
NYDEC'1A-371 J, NYOCA 483056
3J
beQsLo8 anporLaUon o. 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 ,
1. work Site Name and Mailing Address Owner's Name, Address, Phone Number
BROWN BROTHERS HARRIMAN BROWN BROTHERS HARRIMAN
63 WAL.'!: ST. . 63 WALL ST.
NEW YORK, N.Y. NEW YORK,N.Y.
Contractor's Name, Address Waste Disposal Site
TRIO MEADOWFILL LANDFILL
14-20 129TH S'T'REET RT. #2, BOX 68
COLLEGE POINT. NY 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 Yds. -
47
Q Waste Asbestos, Class 9, NA2212, PGIII ❑ Other
Drums or Tons - OTHER -
❑ 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 a curately described above by proper
shipping name and are classified, packed, marked and labeled and are in all respects in p er condition f transport by highway according to
applicable international v rnment regulations. r
e
X
Printed/Typed N e Title Signature Date (M /YY)
Transporter 1 (Acknowledgement of Receipt of Materials)
, Telephone No.
Company Name and Address Signature: 1-924-5050
ASBESTOS TRANSPORTATION CO., INC.
P.O. BOX 1044 Printed Name: A~ Date
HAMPTON BAYS, NY 11946
Title: DRIVER 2
Transporter 2 (Acknowledgement of Receipt of Materials)
elephone No.
Company Name and Address Signal 631-924-5050
ASBESTOS TRANSPORTATION CO., INC.
P.O. BOX 1044 Printed Name• C(, V Date
HAMPTON BAYS, NY 11946 c ay
Title: DRIVER
Discrepancy Indication Space:
Waste Disposal Site 0 or or Operator's Certification (Receipt of Above Waste Accepted)
Telephone No.
MEADOWFILL LANDFILL ' Signature
1 (304) S42-2 S4 Prints me:.1 J4, / i! g ,..; fr1 Date
Company Name and Address Title: e. -9'., 0
NYC-WTC 000112579
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