Invoice for facade remediation services, July 2002

NYC 9/11 Public Portal Document

WX1 WASTE MANAGEMENT CT, MA, RI, VT, NH, ME GENERATORS E.P.A. AGENCY :+-~,^,., NY GENERATORS #99 48754 EPA Region 2 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# ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number .O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC _._._._._._._._._._._._._CARO.I.I.QM .. Address Address 3010 BURNS AVENUE City City WANTAGH State NY Zip 11793 (516)781-3000 Phone Number Telephone Number t i26Ai2 07125A32 Date Container Del. Date of Pickup GENERATING LOCATION Type of Container 100 YARD Address 26 WARREN STREET VOLUME 112 CY Friable Non-Friable ❑ City State Zi BagX Drum ❑ Wrapped ❑ Other ❑ NEW YORK. NY 10001 Phone Number 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 - AAA Transporter 1: FIBER CONTROL INC wttn au ANTA h NY 11733 516-7R1-'V 1 (1 ~~ rame Address Telephone # Driver: `~ ~V Registration #: NY 1420 139 AR Date: 07)24A2 I Signature State / # - Acknowledgement of receipt of materials.

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

Driver: Registration #: ,4"' Date: 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: I Certification of receipt of materials covered by this manifest.

Transporter 3: Name Address Telephone # Driver: istration #: Date: Signature State / # of receipt of materials.

Landfill Name: No: Location: 'ermit,fi Approximate Volume of Asbestos Received: Discrepancy If Any: Received by: Certification of receipt of materials covered by this manifest.

COP" I .GENERATOR NYC-WTC 000112786