Invoice for fiber control services, 181 Broadway, August 2002

NYC 9/11 Public Portal Document

E.P.A. AGENCY #99 48704 CT, MA, RI, VT, NH, ME NY GENERATORS WASTE MANAGEMENT 'GENERATORS EPA Region 2 • LOGANQ EPA New England 290 Broadway, 26th Floor • EMERGENCY RESPONSE P.O. Box 144 - Portland, CT 06480 1 Congress Street New York, NY 10007-1866 (860) 342-0667 • Fax: (860) 342-4866 Boston, MA 02114-2023 (212) 264-6770 TELEPHONE Out of State 1-800-272-3867 (617) 918-1111 #1-800-272-3867

FB# 6024 ASBESTOS DISPOSAL & DOCUMENTATION FORM Job Number P.O. # GENERATOR/BUILDING OWNER Contractor FIBER CONTROL INC. 181 BROADWAY ASSOC. 3010 BURNS AVENUE Address 20 VESEY STREET Address WANTAGH NY Zip 11793 City NEW YORK. NY 100t7P City State 16)781-3000 Phone Number Telephone Number Date Container Del. Date of Pickup GENERATING LOCATION

Type of Container 100 YARD Address 314 1I:l t.l r1?L VOLUME CY Friable' Non-Friable ❑ 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. 5010 . NY 11733 516-7813000 Name Address Te06h1 Driver: Registration #: NY 1480 139 AR Date: tbJ 2 nature State / # Acknowledgement of receipt of materials.

Transporter 2: Waste Mana me .E.E.T., Inc., PO Box 144, Portland, CT 06480 1-800-272-3867

Driver: -' Registration #: ~y_S-7 Date: . ig ature State / # Acknowledgement of receipt of materials.

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

Transporter 3: Name N/A Address Telephone # Driver: Registration #: Signature State / # Howled ement of r ipt of materials.

Landfill Phone No: Location: Permit #4Q Approximate Volume of Asbestos Re ed: 3/4 CY Discrepancy Received by: Certification of receipt of materials covered by this manifest.

NYC-WTC 000122897