Invoice for asbestos abatement, 119 Fulton Street, July 2002

NYC 9/11 Public Portal Document

IESI NY CORPOkATION 410 ,5th Street • BI•okpyn, NY 11215 Phone: 718-522-2263 • Fax: 718-522-269'],/ r,,~, MANIFEST f

1 1238 DATE _ 1. Job Site Address a,.,,, Owner's name Wait and Load 119 Fulton Street Dept Of Em otunetwtal Time In New York, . Y. 1 ,2 > a~t 0t'~~ ' 2. Cggtre •r me a9-ad_dtegs n C ,_ pai

12.48 Ralph Avenue ,1 E Brooklyn, Imo' 11236 //' 7 /7? N E 'e—~'' ' R 3. * 4p a tQUon , WDSphonenumber. Z

T P.O. Box 399 o Scotland, Pa. 17254 Pamt # 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 • 6.VEH. LIC. # / 7. TOTAL QUANTITY (RQ) WASTE ASBESTOS 9, NA2212, III TYPE BAGS SIZE ••-CUBICYARDS 8. Generatoretirtification

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T 9. CONTRACTOR CERTIFICATION: I hereby declare that the contents of this consignment are fully and accutately described R above by proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by A highway according to applicable international overnment regulations.

N S Pnntedrryped Name f Title z Signature / •, Date (M/D1 p 10. Transpor~ of reeeip of materials) .DEC Permit No. R IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 215 .JA.46 , — ~/~/ T II U!/<. DI R` ~/ C r 4) ;/Q Z E Printed/rypedName Title Signature Date M/D/Y J j R 11. Transporter #2 (Acknowledgement of receipt of materials) . DEC PERMIT # W A

T E Printed/Typed Name

12. Discrepancy indication space Title Si re Date(M/D/Y)

S I T X13. Waste disposal site owner or operator: Certification of receipt of asbestos materials covered by this manifest except as noted in item #12 E

V Pri typed Name Title iih r ItkLI Signature 7J3/t2 Date (M/D

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

NYC-WTC 000119598