Asbestos roof cleanup invoice for multiple sites, June 2002

NYC 9/11 Public Portal Document E.P.A. AGENCY #99 48707 CT, MA, RI, VT, NH, ME NY GENERATORS WASTE MANAGEMENT GENERATORS EPA Region 2 • LOGANO EPA New England 290 Broadway, 26th Floor EMERGENCY RESPONSE 1 Congress Street New York, NY 10007-1866 P.O. Box 144 • Portland, CT 06480 TELEPHONE (860) 342-0667 • Fax:(860)342-4866 Boston, MA 02114-2023 (212) 264-6770 Out of State 1-800-272-3867 (617) 918-1111 #1-800-272-3867

FB# 6024 ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number .O. GENERATOR/BUILDING OWNER

Contractor FIRER CONTROL INC. -.-.-.-.-.-.-1ROSLYNHALPER _____ Address AVENUE Address 3010 BURNS city City WANTAGH State NY Zip 11793 ....................................................., Phone Number (516)781-3000 Telephone Number GENERATING LOCATION Date Container Del. Date of Pickup Type of Container 1170 YARD Address 314 Non-Friable ❑ CHA RS T VOLUME CV Friable, City NEW OR YORK. NY 1000 Bag Drum ❑ Wrapped ❑ Other ❑ Phone Number INy #. F1018

defined by 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 and is in proper condition for transportation according to 40 CFR part 261 or any applicable state law, has been properly described, classified and packaged, NESHAP standards for asbestos waste disposal found in 40 CFR part 61.150. proper shipping name, and are Shipper's Certification: I hereby declare that the contents of this consignment are fully and accurately described above by the in all respects in proper condition for transport according to applicable international and national classified, packaged, marked and labeled/placarded, and are government regulations. -~ AUTHORIZED SIGNATURE -=-~ Transporter 1: FIBER CONTROL INC. xS.AVENUE TAGH NY 11793 i6-781-3Q00 A r Telephone #

Driver: Registration #: NY! 480 139 AR Date: 06/19102 ignature State / # Acknowledgement of receipt of materials.

Transporter 2: Waste M gV nt N.E.E.T., Inc., PO Box 144, Portland, CT 06480 1-800-272-3867

Driver: Registration #: /T '"C Date: ~-- - Signature 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 1130723 Received By: N/A Date: Certification of receipt of materials covered by this manifest.

Transporter 3: Telephone # Name Address Driver: Registration #: Date: Signature State / # Ac owledge ent of receip aterials.

Landfill Name: Phone No:

Location: Z Permit

Approximate Volume of Asbestos Received: 3,/4 GY Discrepancy If Any: Received by: Date: 2Y — aZ— Certification of receipt of materials covered by this manifest

NYC-WTC 000122095