Invoice for roof remediation work, 25 Beekman Street, July 2002

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IESI NY COR POR A TION 110 5th Street • Brooklyn, T' 11215 Phone: 718-522-2263 • Fax: 718-522-2697 MANIFEST }} i 11103 DATE I. Job Site Address Owner's name Wait and Load 25 Beekman Sired Dept of Ei irolniental Time In N Y New York, N.Y. Protection Time Out

2. Cgytractor's name sgdaddreG Drop Date t enj~'Illfl ! lll ~z[?n[! & Son 1248 Ralph Avenue E Brooklyn, NY 11236 N E R 3. !h li a ft jMtion WDS phone number

A P.O. Box 399 -o Scotland, Pal. 17254 Pennk # 100934 R

4. Name and address responsible agency (Local, District or EPA Office where notification was sent)

US EPA 290 Broadway, New York 10007

5. Description of materials /J/ F 6.VEH. LIC. # 7. TOTAL QUANTITY

(RQ) WASTE ASBESTOS 9, NA2212, III TYPE ' BAGS SIZE CUBICYARDS 8. Generator Certification

T 9. CONTRACTOR CERTIFICATION: [ hereby declare that the contents of this consignment are fully and accutately described R abov ; by per shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by A high a o ng to ap livable international government regulations. N S Print ypedName Title Signature Date M/D P 10. Transporter #1 (Acknowiedj«nan of receipt or ma n ls) DEC Permit No. O IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 1 L2.375 JA-462 R

E Printed/Typed Name Title Signature Q Date M/D/Y r R p 11. Transporter #2 (Acknowledgement of receipt of materials) I DEC PERMIT # W i I f T PrintediTyped Name Tit ' " Si to /D/r' T E 12. Discrepancy indication space r ,

S I

T 13. Waste disposal site owner or operator: Certification of receipt of asbestos materials covered by this manifest except as noted in item #12 E

It v nted/Type Name l -- 'r a Si we Lj4 . Date (M/D/Y)

WHITE:LANDFILL • GREEN:IESI • PINK:GENERATOR • YELLOW:CONTRACTOR • GOLD:JOB SITE

NYC-WTC 000118736