38A-050 (9) SITE ARRIVAL TILIE: DELIVERY: Waste Management
SfTEDEPARTUI)ETRAE: PICKUP: New England Environmental
Transport,Inc.
W^S'M MAMAGEMErwrr fAANIFESTfi: P.D.Box 144
Pordand,CT06460
Ticl .=.t . 17 ICIE Drive •: SANS TPJ) 'j(T�jC Date Ite a w[H�nD)3247221-66W7
I
Opei.ed I-Jy. LCADAVID te. Di;-=r,a te_fI,7--1 1- , I,
.0
CUB' (:)Mel,: 298_r,)28, MOTELLCA )I
IS ;`�;.%A'AjN1-NJH'f-j'_PTX. H(_)SP-A
RT 66
NORTHAMPTPH HA 01061 5 0 3--1.)
ROD HOLMEej
�rpieFtc,-: by: ROB01 DONI)
T o; J Type: LIVE LCIAD�, q f
I Duiip Site:
ZD�K: ice
A We i-ght
BOY DIENIP TFLATLER ASBFSTIJ&'
65 LIP TAW,,'NA-'
M
DTD: SUBBED SAmS
Er LL I DUP W/2-10 MIL-PW OW SITE
IS i gn a-u u r e
L
COMMENTS:
VIM
WVI� E.P.A. AGENCY ;; ; �,
N'E•E'T• CT,MA,RI,VT, NH,ME NY GENERATORS # �� t J
WASTE MANAGEMENT GENERATORS �--r- �'.`.? /� -
�i C=t;? / 1 -�
New England Environmental Transport,Inc. EPA Region 2 EPA New England 290 Broadway,26th Floor 6E�ENCY RESPONS
P.O.Box 144•Portland,CT 0(x180 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
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number (—)7 .1(( P.O. #O? r+ GENERATOR/BUILDING OWNER
Contractor /'�,,<�r';r /il
Address_ � ,: �a J c.s �,— Addres
City I o State _011A-Zip t 27 City l ^ State Zip
'i r l i 1
Telephone Number Phone Number
Date Container Del. Date of Pickup =���/�z GENERATING LOCATION
Type of Container A: ,r,6
VOLUME 6'_� CY Friable ❑ Non-Friabl Address . � '' r;Y' � rC. � • - �_
MUST BE IN CUBIC YARDS c 7
City State Zip
BagA Drum ❑ Wrapped ❑ Other❑ Phone Number '
RQ, ASBESTOS, 9, NA2212, PG III
1 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 properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE _; ' `;�-
�J /
Transporter 1: f3
e Addr ss r
J� Te eph ne#
Driver: /1 �+� Registration #: h ?�/ �� Date: /^
Signature State/#
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T. Inc. PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. - 203 PICKERING STREET- PORTLAND,CT 06480-PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address
Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name- Z �— rr Phone No:
Location: h Permit
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
COPY 2-CONTRACTOR
SITE ARRIVAL TIME: DELIVERY: Waste Management
thew England Environmental
wv�n. SITE DEPARTURETIME: PICKUP: Transporl,Inc.
htA1MAGFMr.VJr ;- P.O.Box 144
MANIFESTfi: L 1, Portland,CT HALO
(PDO)272 ,867
`Picket : 1.710 ':7AMS TRUCKII,'(1 e P e--! ) - I'
• " 1,-z 41/200':'
Opened by : 11CADAVID Dzi e rzr,t e,-j C.
Customer 208-2284 C,)12 TEL"0 D1S-,'-'j'AN--MHYjPTN HOSP-A
R T 66
WORTHAHMPN MA 01(-)(--Il 5"-),:"- 8-x;;81
Attn . : ROB J,10 L�1.rE.5
Requested ')Sr: 2 B( IOAM)
J-
Load Type LIVE LOAD
map. ("n d I-- -M a v, CD ImOR
Pump Sit-,e :
V: r J-r.!t on
Service �-i a v d-.7 Weight Job sr�c-- •
60Y DUI-11' TRAT-LER A':j--'kEc-!TOS 65 Li' T A Ni ,'NA'
E
D1 N: SUBBED ISAMS
LL 1 DT W/'2-10 M-(L-PV-1 ON, S I T 7E
COMMENTS:
Wva N.E.E.T. E.P.A. AGENCY # 99 79.972
CT,MA,RI,VT,NH,ME NY GENERATORS
WASTE MANAGEMENT GENERATORS
New England Environmental Transport,Inc. EPA Region 2 EPA New England 290 Broadway,26th Floor EMERGENCY RESPONSE
P.O.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 1-800-272-3567 (617)918-1111 �14 S t.
�=�o r l t_F J- --_�(o t J t= #1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number i i I P.O. #'> GENERATOR/BUILDING OWNER
Contractor ( ;'
Address - Address
City State 6'`°�' Zip City State Zip
Telephone Number a- Phone Number
Date Container Del. Date of Pickup GENERATING LOCATION
Type of Container
VOLUME CY Friable ❑ Non-FriableE- Address
MUST BE IN CUBIC YARDS city ; State . Zip
Bag ❑ Drum ❑ Wrapped ❑ Other❑ Phone Number /
RQ, ASBESTOS, 9, NA2212, PG fit
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 properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE
Transport r 1: C);x, Ck��TC�(c1'f,r���1. 'r .S�'-�:fit►'%`
Name
Driver: y Address � DQ _Te phong•#
D
Registration #: 0(04 .`P56 � k- Date: i �
Signature State/#
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc. PO Box 144, Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET- PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:S3ern
Name Address
Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: ( Phone No: b 0-38-6-0"A I
Location: OC#f STETZ NIECK RJ "i'E[2 f �J, Permit#: QC/ COQ j
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
COPY 5- COPY
SITE ARRIVAL TME. Af"LLC 41'22 DEUVERY: Waste Marlaymmi
grTE DEPARTURE TIME:
New England EnVrapmenf a(
PICKUP. Transport,hr.
WASWE MANAGEMENT IAANIFEST#-. P.O.Box 144
Portland,CT OG460 •
IND)272.3fj67
T ick e t 17 109 Driver : 2'AMS TRUCIKINTO e i i t7 (&k)3424,4% /*
Opened by : LCADA V T
-L D �"'atr- Eli 121 D r�
CUFtamer : 298-" i L -1.
.2 13,1 CC,STE LLO I PT R 1X)(`-['-A
R T e,G
M 0 1-1,
TpANIprrp
X M 010(31 50�-958-92 •
Att") . ROB HOLMIE(-'
Red-.tested bit: ROD
Load Type : LIVE LOAD
Leap Ch-CF
K�p
Dump to ',-ql-TfJRIQKEY' NFACM/',Tbi4* "2-"O*-,-I"-'63
w!
Pe ry ic&
Yard W•7 ji'rht
L t i C'
GOY DUM!P TRAIT- A'-7
.W 65 LF TAN/Nin.'CIA
-qAMS
LL I DT MIL-PW I T E
A&
low
Signature:
COMMENTS:
Vv�a N E E T E.P.A. AGENCY # 99'7 g 9 71
CT,MA,RI,VT, NH, ME NY GENERATORS
WASTE MANAGEMENT GENERATORS \iY2 0
New England Environmental Transport,Inc. EPA Region 2 V.J✓ (O� /V/�
EPA New England 290 Broadway,26th Floor EMERGENCY RESPONSE
P.O.Box 144•Portland,CT 06480 1 Congress Street New York,NY 10007-1866
(860)342-0667 • Fax:(360)342-4366 Boston,MA 02114-2023 (212)264-6770 TELEPHONE
Out of state 1-800-272-3867 (617)918-1111 #1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number P.O. #oz,H)_ ,n GENERATOR/BUILDING OWNER
Contractor OS—r-, ,,
Address "7 �,,.y �— Address
City — �j ?r�;7. : .. . State ,1 Zip ,!,,�� �> City wS�tlate �ZiP
Telephone Number z,;� '--f;_;.4 n c,-; Phone Number1
Date Container Del. r /c:X, Date of Pickup e.y/.�/ GENERATING LOCATION
Type of Container All r7( A"'I _ l ,c - 1 � !i7��„*�.r:
VOLUME /5 CY Friable ❑ Non-Friable Address
MUST BE IN CUBIC YARDS
City State Zi p
Bag Drum
Wrapped ether —
g pp ❑ Phone Number
RQ, ASBESTOS, 9, NA2212, PG III
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 properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE
Transporter 1: L`3 °. �'`1 / c -.!Q`
Name //i jj Address (1 Telephone#
Driver: e ,. .;Registration #: 6/!, 41� Alf, Datt -� -7—"
Signature State/#
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc., PO Box 144, Portland, CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559•PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit #:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
(`nPV r3 frnK1-rQAr%Tno
VJR N.E.E.T. E.P.A. AGENCY # gg 79974
CT,MA,RI,VT,NH,ME NY GENERATORS ' /
WASTE MANAGEMENT GENERATORS v / /
New England Environmental Transport,Inc. EPA Region 2 J�/(p/ /Z/
/
EPA New England 290 Broadway,26th Floor
P.O.Box 1.4•Portland,CT 06480 1 Congress Street New York,NY 10007-1866 EMERGENCY RESPONS
(860)342-0667 • Fax:(860)342-4866 Boston,MA 02114-2023
Out of State 1-800-272-3867 (617)918-1111 (212)2sa-s77o TELEPHONE
#1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number !; I P.O. #,0?Il GENERATOR/BUILDING OWNER
Contractor �.�S7 c t .h � M.��,{� -, I/I. �7
c�n17
Address Address ,/� � 11
City �`11;'���r 1=,�:�,,.r, State Zip 0Z—�4 -- City State 1�t427
Telephone Number ,`= --�; ?rJ Phone Number 7u "� -
Date Container Del. . /1 1,3 Date of Pickup—J GENERATING LOCATION
Type of Container
VOLUME r;S CY Friable ❑ Non-Friable Address
MUST BE IN CUBIC YARDS City State Zip
Bag❑ Drum ❑ Wrapped Other oIo-
.: � Phone Number
RQ, ASBESTOS, 9, NA2212, PG III
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 properly described, classified and packaged, and is in proper condition for transportation according tc
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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE'/r %'
Transporter 1: '
Name i' i - Address Telephone q J '
Driver: , - - .f r Registration #: n - lU?34x_ J71L-i Date:
Signature State/#
J Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc., PO Box 144, Portland, CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: Z i� Phone No:
Location: = ,� Permit
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
WVR N E'E T E.P.A. AGENCY V5 3 061 N # 99 �"� 7 ,9 09 81
CT,MA,RI,VT,NH,ME NY GENERATORS
WASTE MANAGEMENT GENERATORS -
New England Environmental Transport,Inc. EPA Region 2 EPA New England 290 Broadway,
P.O.Box 144-Portland,CT 06450 26th Floor EMERGENCY RESPONSE
1 Congress Street New York,NY 10007-1866 t
(860)3.12-0667 - Fax:(860)342-4S66 Boston,MA 02114-2023 (212)264-6770 TELEPHONE
Out of state 1-800-272-3567 (617)918.1111 #1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number 17 f I P.O. # 117 111 GENERATOR/BUILDING OWNER
Contractor ...t ill4
%� l�r�,^ ti , , '" Address
Address
City i�'� ..�}�};t y?,,,rn —State.'�'`� Zip 77,z�r.i City state zip
Telephone Number Phone Number
G13 Y 7 �4n
Date Container Del. ca`'� Date of Pickup ;� ,.� GENERATING LOCATION
Type of Container 4/Z �r , f�l;.�� /v�.!_;::..�;,.- .L7-f
VOLUME 6:1<' CY Friable Non-Friable'a;; Address
MUST BE IN CUBIC YARDS City / _ r State Zip
Bag ❑ Drum ❑ Wrapped ❑ Other❑ Phone Number
RQ, ASBESTOS, 9, NA2212, PG Ill
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 properly 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 in all respects in proper condition for transport according to applicable international and.national
government regulations. -r _
AUTHORIZED SIGNATURE
Transporter l:
-14ame Address Telephone#
Driver: Registration #: Date:
`Signature" _ State%#
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N E E T Inc PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. - 203 PICKERING STREET- PORTLAND,CT 06480-PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit#:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
COPY 2-CONTRACTOR
V%VR N.E.E.T. E.P.A. AGENCY 3 aG lam# 99 7998-
CT,MA, RI,VT,NH,ME NY GENERATORS
WASTE MANAGEMENT GENERATORS ,
New England Environmental Transport,Inc. EPA Region 2 EPA New England 290 Broadway,26th Floor EMERGENCY RESPONSE
P.O.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 TELEPAONE
Out or state 1.800-272-3867 (617)918-1111 #1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number 07- 111 P.O. #07 W-I, GENERATOR/BUILDING OWNER
Contractor �l'27E?r-Lc7 41 - <..,:, ,r, „( �T
Address 2 j1�^;-; _ ,�». ���} Address 4 r�lJrti1A /�Z
City ^Y'; State gtr Zip -C-77- =rs, City E v�/L ��State 'Zipl'
Phone Number
Telephone Number ;61 r
Date Container Del. =F% �f�r� z Date of Pickup GENERATING LOCATION
Type of Container
VOLUME ; CY Friable ❑ Non
-Friabld ] Address
MUST BE IN CUBIC YARDS City State Zip
Rag ❑ Drum ❑ Wrapped ❑ Other❑ Ph i`,/;;;1�;,,�,`•=•,:, ����•> >', '`,
or Number
RID, ASBESTOS, 9, NA2212, PG III
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 properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE �� -
Transporter 1: ^r < T.-„ :j,7- . r;•, ,y �-�.�.� �/ s^h /.�"i
Name Address Telephone# .
�c
Driver: Registration #: Date: =7//�'/'✓
.Signature State/# --
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit#:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
C(SPY 9.r0KITRACTQR ___
N E E T E.P.A. AGENCY . V -7 00//
CT,MA, RI,VT,NH,ME NY GENERATORS 99 9 7 9
WASTE MANAGEMENT GENERATORS
New England Environmental Transport,Inc. EPA Region 2
P.O.sox 144•Portland,CT 06430 EPA New England 290 Broadway,26th Floor EMERGENCY RESPONSE
1 Congress Street New York,NY 10007-1866
(860)342-0667 • Fax:(860)342-4366 Boston,MA 02114-2023 (212)264-6770
Out of state i-800-_7_'-3867 (617)918.1111 TELEPHONE
#1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number 02,.(! c� P.O. #.(7Z,/1") -r v GENERATOR/BUILDING OWNER
Contractor �n ��i i,, �-;X1.4.,, T—��.�,C— Aet i5
Address 7 . li�sC�: ��;-�r'.+ , - Address
City ';/1 .� r,?1 ,r City , State
y , _ r, State �, Zip r,Z. r; if _ Zip
Telephone Number ;n �: f ��,u� C Phone Number
Date Container Del. s.1,�;',; Date of Pickup ,t:..Ll GENERATING LOCATION
Type of Container
,!
VOLUME Z7' CY Friable ❑ Non-Friable,Q� Address
MUST �, �.�,�
MUST BE IN CUBIC YARDS
City f State Zip
z
Bag ❑ Drum ❑ Wrapped ❑ OthPr[� `�''f'yam, fir; A
Pt_n, Number
RQ, ASBESTOS, 9, NA2212, PG III
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 properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE
Transporte 'i
Address - Telephone#
t'„ r
Driver: Registration #: , r , , Date:
Signature r State 1#
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T. Inc., PO Box 144 Portland CT 06480 1-800-272-3867
Driver: ` r Registration #: Date: ^� � -
Signature State/# `
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559•PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State!#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit#:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
rnPV 0_f1nA1TQeP'TnQ
/
New England Eovirrnmenlal
-IT 1315
60Y DUMP TRkT.LER ASBEcTOS.-
VIM 20443700
M VR NEE T E.P.A. AGENCY V5 3 vG 1v F #
CT,MA, RI,VT,NH,ME NY GENERATORS 9979978
WASTE MANAGEMENT GENERATORS
New England Environmental Transport,Inc. EPA Region 2
EPA New England 290 Broadway, MERGENCY RESPONSE
P.O.Box 144•Portland.CT 06480 1 Congress Street Y 26th Floor
(860)342-0667 • Fax:(860)312-1866 g New York,NY 10007 1866
Out of State I-800-272-3867 Boston,MA 02114-2023 (212)264-6770 TELEPHONE
(617)918-1111 #1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number e57 P.O. #102,110-1 a GENERATOR/BUILDING OWNER
Contractor -�i f i� _v p,�fry 4, f� 1 &_1�et o 'rH tIN?
Address 1 r.,,—�1�. (, �-.F Address`//�
�-�. �' �'T'i�
City j rn o State Zip n?,3q 4 City ��vEFrvc fLl Ye v/ 'p
Telephone Number
r Phone Number
;r�4's ��-6 �-�£'v �,I
Date Container Del. Date of Pickup o GENERATING LOCATION
Type of Container �r.-
VOLUME r CY Friable ❑ Non-Friable r Address
MUST BE IN CUBIC YARDS `
City fate Zip
Bag❑ Drum ❑ Wrapped ❑ Other❑ 'rte<r �"'�°^
Phone Number
RQ, ASBESTOS, 9, NA2212, PG III
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 properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE
Transported 1! 1 �" (7_
F(ddress
� Telephone#
Driver: _,.,.,f r -- Registration #: '/ DaIe: t /-I la-7 Signature State/# /
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc. PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit#:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
Waste Management
SFEARRIVALTIME: DELIVERY: New England Envimnmental
SITE DEPARTURETIME: PICVUP:- Transport Inc.
P.O.Box 144
WAUTE rAAP4AXGEMEMI' PortlatA,CT 0CA60
JAAMFEST4".
(WO)272-3867
T i clv e t 17--. 1�j '�71AKS� 'TR U C j",T ILI T'late Kle�-
Date E, a t-o I- c- -
Opened by : LCADAVM
Customer C T-l"F L-T 0 T,"r SMA 11-11--M 1-3�ff-TN'
RT 66
NORTHAMPTPIj ',/,,A 01001 5 0 S-9 S 9 1
ROB HOLMES
M
I; Requested by R.C'r,(2,3 0 2 11 - % �
Map Gode. : 4
Load Type. LIVE LOAD-*. ..- !.,;7, —
A
D u m 1.) �S it F-� Mel-TURNIXEY. NFACM/T. N �:o 3
Service rd o "'Je ij�,ht Job c i-i p t j 11
60Y DUMP TRhT.LER ASBESTOS.*.. 4,m.0.0 65 LF TAN/ N
U0
DI R: SUPPED SAMS
LL 'A DT W/2-10 FIL-PLq f,!J4 S 11.1!,
COMMENTS-.
VIM NM 02.%
WVM N.E.E.1 E.P.A. AGENCY t�3aZ/fr' # 99 7
CT,MA, RI,VT,NH,ME NY GENERATORS 1
WASTE MANAGEMENT GENERATORS
EPA Region 2
New England Environmental Transport,Inc. EPA New England 290 Broadway,26th Floor EMERGENCY RESPONSE
P.O.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 1-8W-272-3867 (617)918-1111 #1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number P.O. #C->I/16—10- GENERATOR/BUILDING OWNER
Contractor 4Q-7 C,�,t,q u: .cif
!l- c'UPt.oFA fly—I
Address ��,�ir , r>,t Address ✓' � ��
City IOC I'.rte+�� State ;`/ Y- zip city r ` see
Phone Number
Telephone Number �-r Gi'�-�. n.r��'�i
Date Container Del. ': 5 Date of Pickup GENERATING LOCATION
Type of Container
VOLUME G ti CY Friable ❑ Non-Friabl Address
49, -r
MUST BE IN CUBIC YARDS
City State zip
Bag ❑ Drum ❑ Wrapped ❑ nther n Numb
F7, Phone idumber
RQ, ASBESTOS, 9, NA2212, PG III L
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 properly 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 in all respects in proper,condition for transport according to applicable international and national
government regulations.
AUTHORIZED SIGNATURE
Transporter 1: - �r.•� r/.; ;'n�J' .� -c� ; Gi% / fl j? �L'? ? (:f
Address Telephone# f
Driver: t �;- 1 Registration #: :� �3 J :2• Date: :t
f Signatt Fie "State/# 7
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc. PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit #:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
n
i
DELIVERY: Waste Wria •
CITEARRIVP.LTIL�E,�^�� gemenl i
New England Environmental
e SITE DEPARTURE TIME:' , %1JPICKUP: Transport,Inc.
N
_ WASTE MAJVAGEMET ••�r /t / P.O.box 144
MANIFEST#: PortlanJ.CT OM60 •
(Sr )�2-assn
Ticket: 17 110 Driver:
�l j(c _ 1 1� � •
®
Customer: T208-2264 COSTELL0 D'!:HIV N-!�HMPTH flOC-.-f: Date Li_sr:atcl:�>d :
RT G ✓
Lg0RTM1l2TPN ?•1A 0106- ;0b 53-92-'61 .
Attn. : ROB HOLI.1ES
Requesteca IDy: RDS(1Ptl)
m Load Type : LIVE LOAD f tJ,i r 1e P, CC.de-
Dump Site: L-f-TURN KEY:: 4FACH/T01I.-Z 01 d3
Service Cuantity '-rd� tt�
Job
E GOY DUMP TDATLTIE z ASBESmOS: F5 F r TA?l.%vACt1 ��; - T
ob .��t.'
DT TE
rya
r h it 1 COMMENTS:
NTA 204•�Z B
(
C E.P.A. AGENCY
WVM `
N•E•E'T• CT,MA,RI,VT,NH,ME NY GENERATORS # 99 79976
WASTE MANAGEMENT GENERATORS
New England Environmental Transport,Inc. EPA Region 2
EPA New England 290 Broadway,26th Floor EMERGENCY RESPON'
P.O.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
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number . b Z J ►il P.O. #i,P.I!I—!n GENERATOR/BUILDING OWNER
Contractor 111->5� � ,,� S.:�r�t;1!%L �✓—C ��lfi- ��f�;�'inP�a�r%J7
Address—2— "7 i.L-I-i. Address
` . t a �� City /Yla
City �' r' ,?i� r., t State tt , Zip 2 � zip
Telephone Number EL:Sr ---I ; �o� Phone umber -
4r7
Date Container Del. Date of Pickup GENERATING LOCATION
Type of Container rlol�., ! 1.' >� !Y ,'/ ✓.zr ,r�� .f-rr I;-••
VOLUME 6 5 CY Friable ❑ Non-Friable``" Address
MUST BE IN CUBIC YARDS City ' State Zi
Bag � ❑ Wrapped Number
Drum Wra Other '! _ -- I/-- `_ -- —S����
❑ ❑ Phone
RQ, ASBESTOS, 9, NA2212, PG III q :7 6-3 4t-,>
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 b
40 CFR part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper condition for transportation according t
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 arf
classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and nationa
government regulations.
AUTHORIZED SIGNATURE
Transporter l: %._S �� ltf'�/
_..Name r �"� ' Address / T j Telephone#
� Date#Driver: Registration
Signature-'-' __ 1
State/# °�
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T., Inc., PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559-PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone x
Driver: Registration #: Date:
Signature State!#
Acknowledgement of receipt of materials.
Landfill Name: Phone No:
Location: Permit#:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
SITE ARF!VALTIME:
Z/ DELIVERY: YJasle Management I
New Eng and Environmenlal
SITE DEFARTURE TIME: 4 s/c PICKUP: Transpr 1,Inc.
®_ WASTE MANAGEMENT �--�- '-7�,�� �' P.D.Flom 144
MANIFE5TN:Tj / f�� PoillanJ,CT0CM30 •
Ticket: 17110 Driver,: 2A�9�' TR`J(�"?:•'' Y - (Anne�2?es�
Opened by: L(."ADAVII> . . ,�, ��: �a:,a
Date L,_spatci:ed . 04,'09�`31103 .
Customer : 208-22B4 CO'.3TELL0 DISNAN-!HMPTiI t;L,
RT 66
NORTRAMPTPN MA OlCh3i F:UB-953-92i i
Attu. : ROB l 1011:5
Req>, ested lry: RDB(!Pll)- 4 .1 ,
v�
LoE d Type : LIVE LOAD. � r•f,5 p t ocle �
Dun U, Site- r Ll-Tf?RlgUY .NFACH/T014 .2 01 *0
• Service Quantity I' r_rj. 11�.. . '� Joi
E GOY DUMP T^AT'E L AS-ESTOS: 1' 00 TAN,"N +_H
._..
u
DIF: SUBPED SP,MS .
L7. I �T
f f II COMMENTS;
�1�A 204-UL 8
WWRN.E.E.1 E.P.A. AGENCY # 9� 79 75
CT,MA, RI,VT,NH,ME NY GENERATORS
WASTE MANAGEMENT GENERATORS � ������
New England Environmental Transport,Inc. EPA Region 2
P.O.Box 144•Portland,CT 06,480 EPA New England 290 Broadway,26th Floor EMERGENCY RESPONSE
1 Congress Street New York,NY 10007.1866
(860)342-0667 • Fax:(360)342-4866 Boston,MA 02114-2023 (212)264-6770 TELEPHONE
Out of State 1-800-272-3867 (617)918-1111
#1-800-272-3867
TK# ASBESTOS DISPOSAL & DOCUMENTATION FORM
Job Number —�
Contractor I I I f-i P.O. _ GENERATOR/BUILDING OWNER
�
4 �,�'L�c'CV',�^r.�l'7
Address Address'
City %' C�t r c r , State %t Zip ;..1.� City stat Zip
Telephone Number Phone Number
Date Container Del. %J Date of Pickup 7 �a
GENERATING LOCATION
Type of Container , �1
VOLUME F5 CY Address r l �
Friable E] Non-Friable
MUST BE IN CUBIC YARDS -?'
City State Zip
Flag ❑ Drum ❑ Wrapped ❑ Ot ' '. fir- •'11�'%,2___�
Phone Number
RQ, ASBESTOS, 9, NA2212, PG III -1,�-�- ,, ? 6?4,
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
,10 CFR part 261 or any applicable state law, has been properly 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 in all respects in proper condition for transport according to applicable international and national
government regulations. r;
AUTHORIZED SIGNATURE
Transporter 1: ✓L! C / �1��� ��� , .r- !��`k .it y/ �- L fti_) /'rl+t f !1' �� ��Sj
Name Address— Telephone#
Driver: t,::z--f ' Registration Date: ,r
Signature State/#
Acknowledgement of receipt of materials.
Transporter 2: Waste Management N.E.E.T. Inc. PO Box 144 Portland CT 06480 1-800-272-3867
Driver: Registration #: Date:
Signature State/#
Acknowledgement of receipt of materials.
WASTE MANAGEMENT N.E.E.T.,INC. • 203 PICKERING STREET• PORTLAND,CT 06480•PHONE:(800)272-3867 PERMIT#1130559•PO
Transfer Date: By:
Discrepancy:
Certification of transfer of materials covered by this manifest.
Transporter 3:
Name Address Telephone#
Driver: Registration #: _ Date:
Signature State/#
Acknowledgement of receipt of materials.
Landfill Name: _T,r%�r_ Phone No: �., 2 - .3
Location: �,G/ -�,`:./' / Permit #:
Approximate Volume of Asbestos Received:
Discrepancy If Any:
Received by: Date:
Certification of receipt of materials covered by this manifest.
SITE ARRIVAL TIME: DELIVERY: Waste Marlagelneni
New England Environiental
SITE DEPARTURE TIME: PICKUP: Transporl,Inc.
RT B6
Load Type LIVE LOAD
Service
�i�D/1.76{s�vk���%�✓ S�7r t�SPZ rogL
Wood
� c�v3