Invoice for roof cleanup at 47 Broadway, June 2002

NYC 9/11 Public Portal Document

NYDEC 1A-371 NYDCA 483056

CQAbekocsd~o///ramporLaLion ., 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 Manifest # IJob # Floor or Location b ust #

1. Work Site Name and Mailing Address Owner's Name, Address, Phone Number

4 BROADV A ' JUNCTION BLVD. S EW YOFk. '% COrONA. `= 1 Contractor's Name, Address Waste Disposal Site RIO lE_iDOW ILL ? ANDr ILL . R ri #2. BOX {,S ;4 -- 20 29TH STREET B .IDGEPORT. W%- . (-.3.1" O ~LEGE I'GI`T. NY Name and Address of Responsible NESHAPS Agency Other l3

U.S. EPA REGION 11, 290 BROADWAY, NEW YORK, NY 10007 Description of Materials Bags - Cubic Yds. - O RQ Waste Asbestos, Class 9, NA2212, PGIII ❑ Other Drum or Tons - OTHER - O 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.

Printed/Typed Name Title Signatu Date (M D/YY) Transporter 1 (Acknowledgement of Receipt of Materials) Telephone No. Company Name and Address Si nature: ~_ 631-924 No. ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 Printed Name: Date HAMPTON BAYS, NY 11946 ~~++ Title: DRIVER C~ ®u Transporter 2 (Acknowledgement of Receipt of Materials) Telephone No. Company Name and Address igna 631-924-5050 ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 rin N Date HAMPTON BAYS, NY 11946 Title: DRIVER Discrepancy Indication Space:

Waste Disposal Sit or pe is Ce cation (Receipt of Above Waste Accepted) Telephone No. ::}L?,DOtYi ILL I. ANDF I LL Signature: ` 3O4)342-2734 Printed Name: Date I

Company Name and Address Title:

NYC-WTC 000118022