Invoice for fiber control services, 155 Chambers St, June 2002

NYC 9/11 Public Portal Document

CT, MA, RI, VT, NH, ME E.P.A. AGENCY NY GENERATORS #99 48712 WASTE MANAGEMENT GENERATORS EPA Region 2 LOGANO EPA New England 290 Broadway, 26th Floor 'EMERGENCY RESPONSE P.Q. 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 GENERATOR/BUILDING OWNER Contractor FIBER CONTROLINC. Address Address 3010 BURNS AVENUE City City WANTAGH State NY Zip 11793 ,._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._. - (516)781+3000 Phone Number Telephone Number Date Container Del. Date of Pickup GENERATING LOCATION

Type of Container Address VOLUME 1n$ CV Friable. Non-Friable ❑ City NEW K. NY iooar Bag• ' Drum ❑ Wrapped ❑ Other ❑ Phone Number

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 property 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 i I respects in proper condition for transport according to applicable international and national government regulations. AUTHORIZED SIGNATURE Transporter 1: FINER CONTROL INC. 3010 BttRM$AVENUI- WAM 1'kCtt. MY 11793 516.7'81 10_ Driver: C nature Address Registration #: NY 1151859 AL State / # Date: Telephone # 06119

Acknowledgement of receipt of materials.

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

Driver: '_/...5~ Registration #: ____________________Date:_____________ Signature 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 # SW 1130223 Received By: N/ A Date: Certification of receipt of materials covered by this manifest.

Transporter 3: Name Address Telephone # Driver: Registration #: Date: Sig State I #

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

COP'? . . GENERATOR

NYC-WTC 000127067