License agreement for debris removal, 49 Broadway, 2002

NYC 9/11 Public Portal Document

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.NYDCC;1 A-371 NYDCA 483056

dV4BbeesLo(6B ransportaLion ., 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 Cust # T 22

I. ork ite N and Mailing Address Owner's Name, Address, Phone Number D.E.P. 25 TRINITY PI_. 581- JUNCTION BLVD. NEW N Contractor's Name, Address Waste °Rj1p P?01ll0 ILL LAND I RT. #2. BOX 68 TRIG BRIDGEPORT. WV. 21,330 14-20 -29TH STREET UOLLEGE POINT, NY Name and Address of Responsible NESHAPS Agency Other O

U.S. EPA REGION H, 290 BROADWAY, NEW YORK, NY 10007 Description of Materials Bags - jCublc Yds.

C] RQ Waste Asbestos, Class 9, NA2212, PGIII U Other Drums or Tons - OTHER - Cl 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.

7 ___________ c3 Printed/Typed Name Title Signature Date (M D/YY) Transporter 1 (Acknowledgement of Receipt of Materials) Telephone No. Company Name and Address Signature: 631-924-5050 ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 Printed Name: Date HAMPTON BAYS, NY 11946 Title: DRIVER Transporter 2 (Acknowledgement of Receipt of Materials) Telephone No. Company Name and Address natur b3lephon 5050 ASBESTOS TRANSPORTATION CO., INC. P.O. BOX 1044 N _______________________________ Date HAMPTON BAYS, NY 11946 Title: DRIVER Discrepancy Indication Space:

Waste Disposal bit O er or Operator's Ce tlon (Receipt of Above Waste Accepted) Telephone No. Signature: Y Y- Printed Nam: Date

Company Name and Address Title: f

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NYC-WTC 000118077