Asbestos fiber analysis report: 173 Broadway, Jun 2002

NYC 9/11 Public Portal Document

CT, MA, RI, VT, NH, ME E.P.A. AGENCY NY GENERATORS #99 48719 WASTE MANAGEMENT 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# G•2' ; ASBESTOS DISPOSAL & DOCUM FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. BROADWAY & CORTLANDT REALTY 3010 BURNS AVENUE Address 28 CORTLANDT STREET Address City City WANTAGH —State--!Y Zip 11793 NEW $? K. NY 1 (516)781.3000 Phone Number Telephone Number Date Container Del. Date of Pickup GENERATING LOCATION Type of Container 100 YARD Address VOLUME 112 CY Friable • Non-Friable p 173 BROADWAY City NEW ?2K, 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 - • 1: FIBER CONTROL INC. L BURNS AVENUE WANT f. MY 11733 518-781.3000

Driver: #: NY 1480135 AR state / # Acknowledgement of receipt of materials.

Transporter 2: N.E.E.T.. Inc.. PO 1-800-272-3867

Registration #:1 F J1.1'.3 *iff2t3' Date: ' d2' Signature State / # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERING-STREET • PORTLAND, CT 0648( I PHONE: (800)272-3867 PERMIT # SW 11302x3 Received By: Certification of receipt of materials covered by this manifest.

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

Landfill

Approximate Volume of Asbestos Received: Discrepancy If Any: Received by: t. _~~ Z~Q4 '" Date: '/ 'o7 Certification of receipt of materials covered by this manifest.

COP", i - GENERATOR

NYC-WTC 000122581