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← Document results/DEP Box 47/57 ANN ST BIN# 1001270 57 ANN STREET 1001270, 92/10
Document / 26 pages

Invoice for asbestos work, 57 Ann Street, November 2002

Machine-extracted title · confidence 98%

Invoice from Benjamin Kurzban & Son Control Inc. for asbestos removal work completed at 57 Ann Street in November 2002.

NYC-WTC_000119704–000119729

Folder label: “57 ANN ST BIN# 1001270 57 ANN STREET 1001270, 92/10

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Scanned page image, NYC-WTC_000119724
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NYC 9/11 Public Portal Document

NL IESI NY CORPORATI • 110 5th Street • Brooklyn, NY 11215 Phone: 718-522-2163•• Fax: 718-522-2697 •` MANIFEST

11016 DATE Owner's name Wait and Load 7 nn Street Dept Of E~tvt .Pre ectiVII Time In

~vew York, N. `1 Time Out

2. Contractor's name and address Drop Date

11 ainin hutzb l t (~!% 71v 2 1248 Ralph Avenue E N Brookll~-n, tit' t 1230 E R 3. Waste disposal site (WDS) name, mailing address and physical site location WDS phone number

T TEST Pa Elt.Ie Ridge Latidtilt Ccrlvtatl+ 0 P.O. Bc,x 399 R Slrotl. ttd. Pa. 17254 Print )- 100934

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

US EPA 290 Broadway, New York 10007

,rq+ 5. Description of materials 6.VEH. LI 1 . # l "wi 7. TOTAL QUANTITY (RQ) WASTE ASBESTOS 9, NA2212, III TYPE C C / BAGS SIZE t' Q j) Eve—• CUBICYARDS 8. Generator Certification o

T 9. << .. L. < C t 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 nd are in all respects in proper condition for ansport by A high,* Cording to applicable international `I government regulations. J

./ - :_. ____________________ S Printed/Typed Name Title Sigilure Date (M/D/Y)

O 10. Transporter #1 (Acknowledgement of receipt of materials) DEC etm1 -`4S2•.No. ~t IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 11215/ JA R D ~,' (. - r Cr /g~~/1 DRIVER n Name Title /Si nature " Date (M/D/Y) L..—" v 11. Transporter #2 (Acknowledgement of receipt of materials) r DEC PERMIT # IEST NJ-46 2

T Printed/Typed Name Title Signature Date M/D/Y E 12. Discrepancy indication space

S

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

t' 1.!t I f ~ 17 Z_- Printed/Typed Name Title Signature Date (M/D/Y)

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

NYC-WTC 000119724

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NYC-WTC_000119724Source: NYC Law Department, mirrored locally

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