Asbestos roof cleanup invoice for multiple sites, June 2002

NYC 9/11 Public Portal Document

E.P.A. AGENCY ,CT, MA, RI, VT, NH, ME NY GENERATORS WASTE MANA*li yT • GENERATORS • 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 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 FIBER CONTROL INC. 267 PROPERTY CORP 3010 BURNS AVENUE Address 267 BROADWAY Address NY Zip 11793 city NEW $ M. NY 1001 City WANTAGH State (516)781 00 Phone Number Telephone Number Date of Pickup GENERATING LOCATION Date Container Del. Type of Container 100 YARD Address 314 CY Friable. Non-Friable ❑ 265.267 BROADWAY VOLUME city NEW 8? K. NY 1 Bag. ' Drum ❑ Wrapped ❑ Other ❑ Phone Number INV #. F1018

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: FIBER CONTROL INC. VENUE

Driver: .~~ Registration # NY 1480139 AR Date: Si ature State / # Acknowledgement of receipt of materials.

Transporter 2: Waste Manje nt N.E.E.T., Inc., PO Box 144, Portland, CT 06480 1

Driver: f Registration #: _______________________Date: / ionature 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 # SW1130223 Received By: N/A Date: Certification of receipt of materials covered by this manifest.

Transporter 3: Name N/A Acaress Telephone # Driver: Registration #: Date: Signature State / # Ackciowleditement ot.reg~t t of materials.

Landfill Name: No: Location: Approximate Volume of Asbestos Discrepancy Received by: Certification of receipt of materials covered by this manifest.

COPY . • GENERATOR

NYC-WTC 000122387