Invoice for roof cleaning, July 2002

NYC 9/11 Public Portal Document

E.P.A. AGENCY #99 4874 L; CT, MA, RI, VT, NH, ME NY GENERATORS WASTE MANAGEMENT GENERATORS 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

FB# ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. 107 W. BROADWAY REALTY CORP 3010 BURNS AVENUE Address 113 READE STREET Address WANTAGH 11793 City NEW MRK• NY 1001P city State NY Zip (516) 01 Phone Number Telephone Number 0Bi262 072 2 GENERATING LOCATION Date Container Del. Date of Pickup 113 STREET Type of Container 100 YARD READE.JTr¢~r Address VOLUME 112 CY Friable Non-Friable ❑ city NEW PiK. NY 100' Bag . Drum ❑ Wrapped ❑ Other ❑ Phone Number INy #; 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 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 II respects in proper condition for transport according to applicable international and national government regulations. AUTHORIZED SIGNATURE Transporter 1: FIBER CONTROL INC. 3010 . NY 11793 516781 ame Address Telenhons_#_ NY 480139 AR 07711224102 Driver: Registration #: Date: Signature State / # Acknowledgement of receipt of materials.

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

Driver: Registration #- I~ P Date: 7 L ignature State! # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERING,STREET' PORTLAND, CT 0648C 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 / # A kn wledge nt of receipt of materials.

Landfill Name: 4 f e2t_.-7 Phone No: 2 Location: Permi Approximate Volume of Asbestos Received: ~ Q9 Discrepancy If An : Received by: Date: C 0 a—' Certification of receipt of materials covered by this manifest.

NYC-WTC 000114756