Asbestos roof cleanup invoice for multiple sites, June 2002

NYC 9/11 Public Portal Document

CT, MA, RI, VT, NH, ME E.P.A. AGENCY NY GENERATORS #99 43719 WASTE MANAGEMENT (~FNFRAT('RR 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# 6•~<( ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. BROADWAY & CORTLANOT REALTY 3010 BURNS AVENUE Address 2.8 CORTLANDT STREET Address City City WANTAGH State--!Y Zip 11793 NEW S?K. NY 1000 (516)781-3000 Phone Number Telephone Number Date of Pickup GENERATING LOCATION Date Container Del. Type of Container 100 YARD Address VOLUME 102 CY Friable k'' Non-Friable ❑ 173 BROADWAY City NEW V 3? K. NY 100' Bag, ' Drum ❑ Wrapped ❑ Other ❑ Phone Number INV # F1027

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. . 1030BURNS AVENUE WANT . NY 11733 516-781 000 Name res Telephone # Driver: Registration #, NY 1480 139 AR Date: 06125A2 Signatu State / # Acknowledgement of receipt of materials.

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

D Registration #: A F JO- fk2k3" Date: Signature State /# Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERINGSTREET • PORTLAND, CT 06481 1 PHONE: (800) 272-3867 PERMIT# SW 1130223 Received By: Certification of receipt of materials covered by this manifest.

Transporter 3: Name Address Telephone # I Driver: Ill1 t Registration #: Date: S gnature State / # Acknowledgement of receipt of materials.

Landfill Name: Location: /2_3 Permit #:_____________________ Approximate Volume of Asbestos Received: \I '1 r., Discrepancy If Any: Received by: ✓~ , ,. Zit4 L Date: a/ y/o 7 / a Certification of receipt of materials covered by this manifest.

NYC-WTC 000122574