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

NYC 9/11 Public Portal Document

E.P.A. AGENCY #99 48739 CT, MA, RI, VT, NH, ME NY GENERATORS WASTE MANA NT GENERATORS ` 4k EPA Region 2 LOGANO EPA New England 1 Congress Street 290 Broadway, 26th Floor New York, NY 10007-1866 EMERGENCY RESPONSE P.O. Box 144 • Portland, CT 06480 (860) 342-0667 • Fax: (860) 342-4866 Boston, MA 02114-2023 (212) 264-6770 TELEPHONE Out of Stare 1-800-272-3867 (617) 918-1111 #1-800-272-3867

FB# 1 ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. SI JIE ME INC 3010 BURNS AVENUE Address 61 BOWERY STREET Address City WANTAGH State NY Zip 11793 city NEW $V K, NY 100'I (516)781-.3000 Phone Number Telephone Number Date Container Del. Date of Pickup GENERATING LOCATION

Type of Container 100 YARD Address VOLUME 1l16 CV Friable Non-Friable ❑ City X NEW 3?2K, NY 100 Bag Drum ❑ Wrapped ❑ Other ❑ 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 . I bVUA

Transporter 1: FIBER CONTROL INC. 3010J'MNS AVENUE ANTAGH. NY 11795 516-731-3000 Name Address Telephone# Driver: Registration #: NY 480139 AR Date: Signature State / # Acknowledgement of receipt of materials.

Transporter 2: 2j Waste Mana eme N.E.E.T., Inc., PO Box 144, Portland, CT 06480 1-800-272-3867

Driver: Registration #:~ ~~ d~,C~Date: tgnature State / # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERING STREET • PORTLAND, CT 06481 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: Signa ure State / # Ac wledgement of receipt of materials.

Landfill Name: Phone No:8111' 44

Location: Permit/~~ G Approximate Volume of Asbestos Received: Discrepancy If Any: Received by: Date: 7 c?L Z

Certification of receipt of materials covered by this manifest.

NYC-WTC 000121821