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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_000119727
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NYC 9/11 Public Portal Document I. - ti

IESI NY CORPORATION 110 5th Street • Brooklyn, NY 11215 Phone: 718-522-263°• Fax: 718-522-2697 r MANIFEST

110'16 DATE Owner's name Wait and Load

7 A'tt1 Dept Of Ent Prk4ect tre Time In ivt's, ' 't'k \ 1 Time Out

2. Contractor's name and address Drop Date

E",&1 lan to Ku l ban & ti nit 1248 Raiph Avenue ~+ E N E;rc~t~kI~ ln. C' 11236 E WDS phone number R 3. Waste disposal site (WDS) name, mailing address and physical site location

1131'•i Pil E file Ridge LaIlAtill C-xjXnt 4ien T O .O. dR .1`l R Scs.taiid. P!. l r_ t°I"tit!! i IOi"i-L

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

US EPA 290 Broadway, New York 10007

6.VEH. LI . # / 5. Description of materials C7 6 "/ 7. TOTAL QUANTITY

(RQ) WASTE ASBESTOS 9, NA2212, III TYPE C e5 • 'BAGS SIZE . Q " 1— , CUBIC YARDS 8. Generator Certification

T 9. ( ;: ; , 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 d are in all respects in proper condition for sport by A highmtdy according to applicable international government regulations.

S Printed/Typed Name Title Si ure Date M/D/Y)

P 10. Transporter #1 (Acknowledgement of receipt of materials) DEC Ilo. O IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 11215/ TA12" R / '.•-~,.~ DRIVER ,./' s!L( 42ES~e6/Typ9lf Name Title /Si nature 7 Date M/D/Y L..-" v II. DEC PERMIT # NJ-4522 Transporter #2 (Acknowledgement of receipt of materials) DES.. W . A r' S Printed/Typed Name Title Signature Date (M/D/Y) T 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

Printed/rypedName Title Signature Date(M/D/Y)

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

NYC-WTC 000119727

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NYC-WTC_000119727Source: NYC Law Department, mirrored locally

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