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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_000119725
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NYC 9/11 Public Portal Document

• tta t =~- IESI NY-CORPORAI 10 — 110 5th Street • Brooklyn, NY 11215 Phone: •118-522-2263 • Fax: 718-522-2697 MANIFEST

1 52 0 DATE I. ;,,b Site Address Owner's name Wait and Load

~ 7 AIm Street Dept Of Fntr Fit otectir n im Nev ''4)ik , t . Y iN Time Out

2. Conlractor's name aqqt~( address Drop Date

-7/, t tit nj.itnhtt 33Itt 2 .i•t .~4 ! i

1 2-48 Ra'ph Avenue rtvklytli, -NY I tj 36 °° E

E R 3. WI1e ji a¢dgliraicals igrction WDS phone number p4aj Y`.~ T T P 0. Box 399 O Sr&'tt l:Indd. Pa. 1 J34 tT1!t# 1O931 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. # 11 ' 7. TOTAL QUANTITY (RQ) WASTE ASBESTOS 9, NA2212, III TYPE {y r l f BAGS SIZE a `! fL. , %} CUBICYARDS 8. Generator Certification a 3a T 9. C O, i P.A C T G R C E R l' I F I C .A T i (_):' ~. I hereby declare thathe contents of this consignment are fully and accutatety described R above by proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition fo'transp by A highway according to applicable international government regulations. N S Printed/Typed Name Title t Signature Date M/D/Y 10. Transporter #1 (Acknowledgement of receipt of materials) DEC Permit Io. O 'IESI NY CORPORATION • 110 5th Street, Brooklyn, 1 15 ; JA-462 R i / t; ~~~ T' E 4i /i4/ n DRIVER : t ` 7/ Z Z i Printed/r}4)ed Name Title 'Si gnature Date M/D/Y R _. 11. Transporter #2 (Acknowledgement of receipt of materials) DEC PE IT # . W A S Date(M/D/Y) Printed/Typed Name Title Signature E 12. Discrepancy indication space

IS ..

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

K E

/ 1

rinted?yped Name Titre '~ Sigtiature Date (M/D/Y) .

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

NYC-WTC 000119725

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NYC-WTC_000119725Source: NYC Law Department, mirrored locally

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