NYC 9/11 Public Portal Document
NYDEC 1A-371 NYDCA 483056
3)
beAo,s /ransporLaLion 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 # I
22
1. work Site Name and Mailing Address Owner's Name, Address, Phone Number
BROWN BROTHERS HARRIMAN BROWN BROTHERS HARRIMAN
63 WAL1. ST. 63 WALL ST.
NEW YORK. N.Y. NEW YORK,N.Y.
Contractor's Name, Address Waste Disposal Site
TR[O MEADOWFILL LANDFILL
14-20 129TH STREET 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.--
Q Waste Asbestos, Class 9, NA2212, PGIII ❑ Other
Drums or Tons -OTHER-
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 a curately described above by proper
shipping name and are cl sified, packed, marked and labeled and are in all respects in p er condition f transport by highway according to
applicable international v rnment regulations.
fr
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: r~ enf Date
HAMPTON BAYS, NY 11946
Title: DRIVER
Transporter 2 (Acknowledgement of Receipt of Materials)
elephone No.
Company Name and Address
Signet 631-924-5050
ASBESTOS TRANSPORTATION CO., INC.
P.O. BOX 1044 Printed Name• G(, L/ r Y- Date
,t17,7
HAMPTON BAYS, NY 11946
Title: DRIVER
Discrepancy Indication Space:
Waste Disposal Site O or or Operators Certification (Receipt of Above Waste Accepted)
Telephone No.
MEADOWFILL LANDFILL Signature
1 (304) S4 ? 54 Prints me: .1 !'f Date
c
Company Name and Address Title: , / , 0
NYC-WTC 000112592
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