Invoice for roof cleanup at 47 Broadway, June 2002

NYC 9/11 Public Portal Document

NYDEC 1A-371 NYDCA 483056

C.,Q4bcQsLoQsPt//ran8p6rLdion .9 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 iCust # 122 ` ID .1. Work Site Name and Mailing Address Owner's Name, Address, Phone Number D.E.P. 47 BROADWAY 5S1"' JUNCTION BLVD. NEW l'OFK,Y .V•. CORONA N.1' Contractor's Name, Address Waste Disposal Site lip, 10 MIEADOWF, ILL LANDFILL 4—_20 1 29TH STRF,ET RT. #2. BON 68 C'OLLI:.'CF POINT. N1' BF.IDGEPORT, WV. 2 t33( Name and Address of Responsible NESHAPS Agency Other O U.S. EPA REGION II, 290 BROADWAY, NEW YORK, NY 10007 Description of Materials Bags - Cubic Yds. - 0 RQ Waste Asbestos, Class 9, NA2212, PGIII U Other Drums or Tons - OTHER - D 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.

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Printed/Typed Name Title Signatu Date (M D/YY) Transporter I (Acknowledgement of Receipt of Materials) Company Name and Address Telephone No. Signature: b3lephon No. ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 Printed Name: Date HAMPTON BAYS, NY 11946

Transporter 2 (Acknowledgement of Receipt of Materials) Title: DRIVER (// /L Company Name and Address Telephone No. igna ASBESTOS TRANSPORTATION CO., INC. 631-924-5050 P.O. BOX 1044 rin N ii Date HAMPTON BAYS, NY 11946 [~,~. 1,. •~' Title: DRIVER Discrepancy Indication Space:

Waste Disposal Sit or pe is Ce 'cation (Receipt of Above Waste Accepted) Telephone No. L.\ N I; != I I. _. Signature: t2-2 Date Printed Name:

Company Name and Address Title: 1A '"

NYC-WTC 000118006