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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_000119726
OCR text

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NYC 9/11 Public Portal Document

• •

as . IESI NY CORPORAñó V 110 5th Street • Brooklyn, NY 11215 • , Phone: 718-522-2263 • Fax: 718-522-2697 A2 MANIFEST

11320 DATE 1 / Owner's name Wait and Load 1. J b Site Addt'eSs ! ] Ann S.t'tte€ Dept Of En1i' Pt ecti n New Yyfk, N. Time Out

2. C rector s name aid adare~s Drop Ciell, 321!3 3433 `'iL'' L C i f 124 Ralph Avenue ale E l;onev 61yt1; NY I I J36 . -

N +_ E ` R ~st It g ad tion WDSphone number 3. W t, A T P0. 39'9 t ox O k .a'*tl3nh#. Pa. 1734 R

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

• ys US EPA 290 Broadway, New York 10007

5. Description of materials_ (RQ) WASTE ASBESTOS 9, NA2212, III F 6.VEH. LIC. # TYPE fi5 (5 /- 7. TOTAL QUANTITY 'BAGS SIZE • t'i— CUBICYARDS 8. GenemtorCertification o Q 4J

T 9. CONTRACTOR CERTIFICATION: I hereby declare thane contents of this consignment are fully and accutate described R above by proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition fo by A highway according to applicable international government regulations. N Z S Printed/Typed Name Title Signature Date M/D -.. P 10. Transporter #1 (Acknowledgement of receipt of materials) DEC I eimit o. +' O SI NY CORPORATION • 110 5th Street, Brooklyn, 1 15 1 JA-462

T r 4ii /jt DRIVER ;. . C. z Z. Ek Pnn Name Title .Si Date(M/D/Y) R w 11. Transporter #2 (Acknowledgement of receipt of materials) DEC PE IT # W A

T Printed/F 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 E

e nted/Typed Name Tn e ` Signature Date (M/Q/Y)

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

NYC-WTC 000119726

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NYC-WTC_000119726Source: NYC Law Department, mirrored locally

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