License agreement for exterior cleanup, 104 Reade Street

NYC 9/11 Public Portal Document

CT, MA, RI, VT, NH, ME E.P.A. AGENCY NY GENERATORS #99 4874"N/ WASTE MANAGEMENT GENERATO _• EPA Region 2 LOGANO EPA New England 1 Congress Street • 290 Broadway, 26th Floor New York, NY 10007-1866 EMERGENCY RESPONSE P.O. Box 144 • Portland, CT 06480 TELEPHONE (860)342-0667 • Fax:(860) 342-4866 Boston, MA 02114-2023 (212) 264-6770 Out of State 1-800-272-3867 (617) 918-1111 #1-800-272-3867

F ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. 104 108 READE ST ASSOC Address 104 READE ST Address 3010 BURNS AVENUE city — NEW SRK. NY 10011P City WANTAGH State NY Zip 11793 (516)781—m Phone Number Telephone Number GENERATING LOCATION Date Container Del. • Date of Pickup Type of Container 100 YARD Address 104 READE STREET VOLUME 1/2 CV Friable, Non-Friable ❑ city NEW V 6~K. NY 100fY Bag ' Drum ❑ Wrapped ❑ Other ❑ Phone Number INV . F1041

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 tc 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 nationa' government regulations. AUTHORIZED SIGNATURE Transporter 1: FIBER CONTROL INC. TAGH NY 11793 316-IS1tiiWU N e Address Telephone # Driver: Registration #: NY 420 139 AR Date: 07124X)2 Signature State / # Acknowledgement of receipt of materials.

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

Driver: Registration #: _____________________Date: Signature State / # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERINGSTREET • PORTLAND, CT 064E PHONE: (800) 272-3867 PERMIT # SW 1130223 Received By: Date: Certification of receipt of materials covered by this manifest.

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

Landfill Name: hone No: Location: Approximate Volume of Asbestos Received: Discrepancy If Any / Received by: t~ • (mil Date: 7~~ — 0 ~-- Certification of receipt of materials covered by this manifest.

CO1'Y i - GENERATOR

NYC-WTC 000114563