Asbestos inspection report, 114-116 Fulton Street, June-July 2002

NYC 9/11 Public Portal Document .~.^.,. '---- -.- n' .. NC'.Ww' f~ " 4`:. .'er --.... --ebr - ---.. .-.. fir•;- ... F. iff- . .. q•0- .-„'.

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IESI NY CO TION 110 5th Street •. Brooklyn, NY 11215 .. Phone: 718-522-2263 • Fax: 718-522-2697 MANIFEST

111/10 DATE e/z 1`/z I . I. ob Site Address Owner's name Wait and Load 1 114-116 Fulton Shied Deptof F,nvl amadel Time In N Y New Yoe1l, ALY. Protection Time Out

2. C j fM a t ~& Drop Date 1248 Ralph Avenue G Brooklyn, NY 11236 E N E R 3. ion WDS phone number A P.O. oz 399 T O 5totlend,Pe` 17254 P it # 10034 R

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

US EPA 290 Broadway, New York 10007

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

T 9. C NTRACTOR CERTIFICATION: I hereby declare that the contents of this consignment are fully and accutately described R abov by per 'pping name and are classified, packed, marked and labeled, and are in all respects in proper condition for transport by A high y g to plicahie international government regulations. N S Printed/Typed Name Title Signature Date P 10. Transporter #1 (.*eknewledgenmt of receipt of materials) 0 DEC Petmit No. IESI NY CORPORATION • 1105th Street, Brooklyn, NY 11215 I JA-462 R

E • PrintetPrypcdName Title Signairt lEd Date R 11. Transporter #2 (Acknowledgement of receipt of materials) DEC PERMIT # W A S ,I. Prlsted ame Title Si Date n 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

I JCL) t3 nuxVT) . Name 7itte Signature Date (M/D/Y

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

NYC-WTC 000128845