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Document / 12 pages

Invoice for roof work at 15 Dutch Street, 2002

Machine-extracted title · confidence 50%

Invoice from Benjamin Kurzban & Son Control, Inc. for roof work completed at 15 Dutch Street.

NYC-WTC_000130799–000130810

Folder label: “15 DUTCH STREET 1001197, 78/7504”

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Scanned page image, NYC-WTC_000130809
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

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IESI NY CORPORATION 110 5th Street • Brooklyn, NY 11215 Phone: 718-522-2263 • Fax: 718-522-2697 MANIFEST 77 1 1 2 4 '1.. DATE 7 / 1 L. 1. Job Site Address Owner's name Wait and Load 15 Dutch Street Dept Of Ellvironzuentel Time In New York, N.Y. P"roteChotI Time Out

2. C t is name ai4~a~dd s~ _ p Drop Date ~~ B:i m lAU1JrLpt $1 ~G 1249 Ralph Avenue G &rookth, NY 11236 E N E R 3. `~ ~tion WDS phone number

A T P.O. Box 399 o Seotland, Pa 17254 Peak # 10+0934 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 LQut~, tl ( ~[+~~► S Piinted/TypedNaxne Tit a Signature Date (M/D - P --- 0 10. Transporter #1 (Ackrawledgemmt of receipt of materials) DEC Permit No. R IESI NY CORPORATION • 110 5th Street, Brooklyn, NY 11215 _ JA-462

T E .S PrintedtTyped Name ,4/-/t; L _.,,. {lc Title Si tore Date (M/DIY) 11. Transporter #2 (Acknowledgement of receipt of materials) DEC PERMIT # W hIo .

S Printed/Typed Name Title Signatu 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

r n

Printed/Typed Name } tF1 b (LiY Title Signature Date(M/D/Y)

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

NYC-WTC 000130809

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NYC-WTC_000130809Source: NYC Law Department, mirrored locally

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