Property and owner information query, 11 Rector Street, Jan 2002

NYC 9/11 Public Portal Document

3L NYDEC 1A-371 NYDCA 483056

CQbeLo QanpoLaLion ., 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 Manife t # Ijob # Floor or Location I Cust #

1. Work Site Name and Mailing Address Owner's Name, Address, Phone Number .ON`: SPV LAS ENTERPRISES i r. 11 RTCTO ST. VL r, . , - YEW YORK. YYk Contractor's Name, Address Waste Disposal Site IIEADr , _' i L T D .. _. s., 41 .l ^^ 1 • OX a 1--2O 12 NTH STREET 3t 1JG~PORT. WV. 2P3. rt _LEEF P0 IYT. 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 s. - RQ 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 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.

_W Fc® Printed/Typed Name Title A(e I-ys 1, x Sig a Date (M/DD/YY) Transporter 1 (Acknowledgement of Receipt of Materials) Company Name and Address Telephone No. Signature: ASBESTOS TRANSPORTATION CO., INC. 631-924-5050 P.O. BOX 1044 Printed Name: 4 tLv Date HAMPTON BAYS, NY 11946 Title: DRIVER Transporter 2 (Acknowledgement of Receipt of Materials) Company Name and Address Telephone No. Signature: •✓ ASBESTOS TRANSPORTATION CO., INC. 631-924-5050 P.O. BOX 1044 Printed Name: ~/~J (, 9 J 7 Date HAMPTON BAYS, NY 11946 Title: DRIVER Discrepancy Indication Space:

Waste Disposal Site Operator's Certification (Receipt of Above Waste Accepted) T ... :11\ Telephone No. 00W=• - I'' ' Signature:

Printed Name: Date

Company Name and Address Title:

NYC-WTC 000113846