License agreement for debris removal, 49 Broadway, 2002

NYC 9/11 Public Portal Document

"1

NYDEC 1A-371 NYDCA 483056

begos ranesportation o., 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 a ifsst # Job # Floor or Location Joust # _-

1. Work Site Name and Mailing Address Ow}er'. Nine, Address, Phone Number

49 BROADWAY 5S1 ' JUNCTION BLVD. NEW YORK. N. . . CORONA .N.V. Contractor's Name, Address Wat .ait AD F I L L. LAND TRIO RT. #2. BOX 6S 14-2U 129TH 'STREET COLLEGE POINT, NY Ba.IDGE ORT. WV. 2 .?3v^

Name and Address of Responsible NESHAPS Agency Other ❑

U.S. FPA REGION II, 290 BROADWAY, NEW YORK, NY 10007 Description of Materials Bags - Cub.c Yds. - Q Waste Asbestos, Class 9, NA2212, PGHI Cl Other I ++o Dram or Tons - OTHER - ❑ 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 Signature Date (M/D Y) Transporter I (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: XV-e ~ !l Date HAMPTON BAYS, NY 11946 / Title: DRIVER Transporter 2 (Acknowledgement of Receipt of Materials) Telephone No.. Company Name and Address Si natur • ASBESTOS TRANSPORTATION CO., INC. 631-924-5050 P.O. BOX 1044 dnted N Date HAMPTON BAYS, NY 11946 Discrepancy Indication Space: Title: DRIVER /~ ~" ~ 1'•—'

Waste Disposal S r rator's Certlfic:atlo eceipt of Above Waste Accepted) IE DOWF I L L LANDFILL Telephone No. 1(304)S42-.284 Signature: Printed Name: D to J Company Name and Address Title: Lr

NYC-WTC 000118079