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Document / 8 pages

Invoice for Benjamin Kurzban & Son, 78 Dutch Street, 2002

Machine-extracted title · confidence 95%

Invoice from Benjamin Kurzban & Son Control Inc. for roof debris removal work at 78 Dutch Street.

NYC-WTC_000130754–000130761

Folder label: “DUTCH STREET 1001198, 78/26

Page image
Scanned page image, NYC-WTC_000130760
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

IESI NY CORPORATION 110 5th Street • Brooklyn, NY 11215 J Phone: 718-522-2263 • Fax: 718-522-2697 MANIFEST /s 11240 DATE 70 / ?- 1. Job Site Address Owner's name Wait and Load ~. 7 Dutch Suet Dept Of FzMro*lmeital Time In New York.. N. Y. Protection Time Out

2. Cppgqtractor's name qpQ address & Drop Date d3enJaiiIn l 6iljjZIPUQ Son 1248 R.lph venue E Brooklyn, Imo' 11236 N E R 3. ,-m 'li lt a i ah jttion WDS phone number

T P.U. &x39 O Scotland, Pa. 17254 Permit # 100934 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. CONTRACTOR CERTIFICATION: 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 A<s-. - u 7 U/ /4Z Printed/Typed Name Titfe Signature Date M/D s P 10. Transporter #1 (Acknowledgement of receipt of materials) DEC Permit No. O R IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 1J,215 JA-462

1ii ic — i — , /ã€--t.-_- /u / ° E Printed/iypedName Title Signature Date (M/D/Y) R 11. Transporter #2 (Acknowledgement of receipt of materials) DEC PERMIT # W

T E Printedlfyped Name 12. Discrepancy indication space Title }_` Si atu Date (M/D/Y)

S I T 13. Waste disposal site owner or oppla1r: Certification of receipt of asbestos materials covered by this manifest except as noted in item #12 E

~ Printed/Typed Name virifk i Title V(c illdl't It Signature i Date (M/D rl~ WHITE:LANDFILL • GREEN:IESI • PINK:GENERATOR • YELLOW:CONTRACTOR • GOLD:JOB SITE e NYC-WTC 000130760

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NYC-WTC_000130760Source: NYC Law Department, mirrored locally

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