Fiber Control Inc. invoice for 114 Chambers Street, July 2002

NYC 9/11 Public Portal Document

E.P.A. AGENCY #99 4 U U 24 CT, MA, RI, VT, NH, ME NY GENERATORS ~_• WASTE MANAGEMENT GENERATORS EPA Region 2 • LOGANO EPA New England 290 Broadway, 26th Floor EMERGENCY RESPONSE P,O. Box 144 • Portland, Cf 5480 1 Congress Street New York, NY 10007-1866 (860) 342-0667 • tax: (860) 342-4866 Boston, MA 02114-2023 (212) 264-6770 TELEPHONE Out of State 1-800-272-3867 (617) 918-1111 #1-800-272-3867

FB# •.cj~Lp ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. SI JIE ME INC Address 114 CHAMBERS STREET Address 3010 BURNS AVENUE city City WANTAGH State NY Zip 11793 NEW NY 1OMP (516)781-3000 Phone Number Telephone Number 06I26)2 07/25)2 Date Container Del. Date of Pickup GENERATING LOCATION

Type of Container 100 YARD Address VOLUME 114 CY Friable Jgl Non-Friable ❑ city State Zio Bag Drum ❑ Wrapped ❑ Other ❑ NEW YORK. NY 10001 Phone Number INV # F1040 I certify the above named material does not contain free liquid as defined by 40 CFR part 260.10 or any applicable state law, is not a hazardous waste as defined by 40 CFR part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper condition for transportation according to NESHAP standards for asbestos waste disposal found in 40 CFR part 61.150. Shipper's Certification: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national government regulations. AUTHORIZED SIGNATURE Transporter 1: ~ y Name ~ Address Telephone #

Driver: c i V~ c c 4 - Registration #: NY 480139 AR Date: 0724A2 Signature State / # Acknowledgement of receipt of materials.

Transporter 2: Waste Manaq , Inc., PO Box 144, Portland, CT 06480 1-800-272-3867

Driver: Registration #: ,~~~ <~ Date: ig ture State / # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERING STREET • PORTLAND, CT 0648 PHONE: (800) 272-3867 PERMIT # SW 1130223 Received By: Date: Certification of receipt of materials covered by this manifest.

Transporter 3: Name Address Telephone # Driver: Registration #: Date: Signature State / #

g ci owie ment of receipt of materials.

Landfill Name* Phone No: Location: Permit Approximate Volume of Asbestos Received: Discrepancy If Any: Received by: Date: '" L ~ ' O Certification of receipt of materials covered by this manifest

NYC-WTC 000121820