Invoice for facade remediation services, July 2002

NYC 9/11 Public Portal Document

.A.ii Z\ WASTE MANAGEMENT CT, MA, RI, VT, NH, ME GENERATORS E.P.A. AGENCY ,., NY GENERATORS EPA Region 2 #99 48754 LOGANO EPA New England • 290 Broadway, 26th Floor EMERGENCY RESPONSE P.O. Box 144 • Portland, CT 06480 1 Congress Street New York, NY 10007-1866 (860) 342-0667 • Fax: (860) 342-4866 Boston, MA 02114-2023 (212) 264-6770 TELEPHONE Out of State 1-800-272-3867 (617) 918-1111 #1-800-272-3867

FB# ' LJ ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. CAROL LONG Address Address 3010 BURNS AVENUE 166 LIVINGSTON STREET City WANTAGH State NY Zip 11793 City BROOOO ~fN, NY 112O ) (516)781-3000 Phone Number Telephone Number t J26R32 07i252 Date Container Del. Date of Pickup GENERATING LOCATION Type of Container _ 100 YARD Address 26 WARHEN STREET VOLUME 111 CY Friable] Non-Friable ❑ city State Zi Bag X Drum ❑ Wrapped ❑ Other ❑ NEW YORK. NY irrnf Phone Number i 1f~.? i 2, ~~ I INV #. F1059 I certify the above named material does not contain free liquid as defined by 40 CFR part 260.10 or any applicable state law, is not a hazardous waste as defined by 40 CFR part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper condition for transportation according to NESHAP standards for asbestos waste disposal found in 40 CFR part 61.150. Shipper's Certification: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national government regulations. AUTHORIZED SIGNATURE Transporter 1: pg CONTROL INC. NY 11733 ~l14me Address Telephone # Driver: __ f (y ~'C Registration #: NY 1480 139 AR Date: 07124)2 Signature State / # Acknowledgement of receipt of materials.

Transporter 2: Waste Man me E.E.T., Inc., PO Box 144, Portland, CT 06480 1-800-272-3867

Driver: Registration #: /~~'//f~~ Date: ) L Signature State / # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERINGSTREET • PORTLAND, CT 06480 PHONE: (800) 272-3867 PERMIT # SW 1130223 Received By: Date: Certification of receipt of materials covered by this manifest.

jt Transporter 3: J 1t Name Address Telephone # Driver: Registration #: Date: Signature State / # ,Dwledge,tit of receipt of materials.

Landfill Name: Phone No: Location: Permit Approximate Volume of Asbestos Received: Discrepancy If Any: Received by: Date: 7-~ - Oa Certification of receipt of materials covered by this manifest.

COP" GENERATOR NYC-WTC 000112786