Invoice from Fiber Control Inc., August 2002

NYC 9/11 Public Portal Document

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t CT, MA, RI: VT, NH, ME E.P.A. AGENCY NY GENERATORS #99 48720 WASTE MANAGEMENT GENERATORS -:

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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# '2, ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. CENTURY REALTY INC Address 140 FULTON STREET 3010 BURNS AVENUE Address WANTAGH State NY Zip 11793 City NEW VftK, NY 100( City (516)7813000 Phone Number Telephone Number ter ___ GENERATING LOCATION Date Container Del. Date of Pickup Type of Container 100 YARD Address 112 Friable ' Non-Friable ❑ 175 BROADWAY VOLUME CV City Bag" Drum ❑ Wrapped ❑ Other ❑ V NEW ? K, NY ioof

Phone Number INV #. F1027 ':. ha:, ?212, 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 Transoorter 1: FIBER CONTROL 10B Telephone # egistration #: NY 1480139 AR Date: 06125102 Driver: State / # Acknowledgement of receipt of materials.

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

Drive #: % ? _ Date: Signature State / # Acknowledgement of receipt of materials.

TEMPORARY STORAGE / TRANSFER FACILITY: WASTE MANAGEMENT N.E.E.T., INC. • 203 PICKERINGSTREET • PORTLAND, CT 0648( PHONE: (800) 272-3867 PERMIT # SW 1130223 Received By: NJ/ t Date: Certification of receipt of materials covered by this manifest.

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

Landfill Name: Phone No: Location: k✓1 ti 1 / [° }',4 /S9zb Permit #:

Approximate Volume of Asbestos Received: a - -

Discrepancy If Any: Received by: Date: n /y%

Certification of receipt of materials covered by this manifest.

COPY t - GEN_r=trTOR

NYC-WTC 000122628