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Document / 27 pages

Invoice from Benjamin Kurzban & Son Control Inc., 111 Fulton

Machine-extracted title · confidence 80%

Invoice for environmental services at 111 Fulton Street with no visible date in excerpt.

NYC-WTC_000128703–000128729

Folder label: “111 FULTON STREET 1001263, 91/1

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Scanned page image, NYC-WTC_000128728
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

IESI NY 6RPORATION 110 5th Street • Brooklyn, NY 11215 Phone: 718-522-2263 • Fax: 718-522-2697 MANIFEST

Al ~Cr9O f DATE Z Z /i~

1. i t, Owner's name Wait and Load Ill Fulton Street Dept 01 EfwAr.) Pt Ct?r.?'!l Time In Nev., Ytk. N Time Out

2. Ct qr, Drop Date ~attt<fla i~ill & slit,

l 24 Ralph Avenue E N 1atOQklyn, N\ 11317 ,~ r

E R 3.W ps srtE . :'~tt i~. altdpA 9 sildlJ(ltion WDS phone number A pl BOX .l'9 T O St• t tlatid, Pa. 17 4 fli t1lt w 101W933 R•

4. Name and address responsible agency (Local, District or EPA Office where notification was sent)

US EPA 290 Broadway, New York 10007

5. Description of materials 6.VEH. LIC. # 7. TOTAL QUANTITY (RQ) WASTE ASBESTOS 9, NA2212, III TYPE ' BAGS SIZE CUBIC YARDS 8. Generator Certification

T 9. C i )`, ( ?- A C T O R C E R T I F [ C '-. T I i I hereby declare that the contents of this consignment are fully and accutately described R above by proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by A highway according to applicable international government regulations. N .fl c:~ ~+ S Printed/Typed Name Title' Signature Date P 10. Transporter #1 (Acknowledgement of receipt of materials) DEC Permit No. O IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 11215 JA-462 R -DRIVER. f ~,~.~,~_~ Z_ _ r1 Printed/fypedName Title Si nature j T Date M/D/Y R 1 1. Transporter #2 (Acknowledgement of receipt of materials) DEC PERMIT # W A Printed/Typed Name Title Signature Date(M/D/Y) T E 12. Discrepancy indication space

S I T 13. Waste disposal site owner or operator: Certification of receipt of asbestos materials covered by this manifest except as noted in item #12 E

Printedlfyped Name X k Title Signature p, Date (Mi )

WHITE:LANDFILL • GREEN:IESI • PINK:GENERATOR • YELLOW:CONTRACTOR • GOLD:JOB SITE

NYC-WTC 000128728

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NYC-WTC_000128728Source: NYC Law Department, mirrored locally

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