RESUB1 BLD2024-1540+WASTE REPORT+12.10.2024_7.58.52_AM+4661374S_
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Regional Disposal
WASTE SHIPMENT RECORD
cress: Owner's Name:
Job #
Container #
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v��� a Ali hWs
6-1)V,6J%b S Ova
(tvA'
2, Operator's Name and Address: .
ONE-STEP ENVIRONMENTAL ABATEMENT
18412 4TH AVE SO.
SEATTLE, WA 98148
3, Waste Disposal Site (WDS) Name, Address, and Physical Site Location:
Regional Disposal Co.
500 Roosevelt Grade Rd.
Roosevelt, WA 99356
4, Responsible Local, State or EPA Agency Name and Address:
PS. Clean Air
1904 Third Ave.
Suite 105
Seattle, WA 98101
5. Description of Waste Materials:
WOOD ..+. Try 4—<51 Ly�: VetS
6. Containers
No. Type
R r ,SSA eo . it
Asbestos Contai ing Materials
Bags
3�v-''lYga7
206.228.4290
1-800-275-5641
m3 1 (yd3)
DOUBLE 6 MIL BAGGED & LABELED
9• OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described
above by proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper
condition for transport by highway according to applicable international and government regulations.
Day
JESSE MAPELLI
10. Transporter 1 Acknowledgment of Receipt of Materials
11. Transporter 2 Acknowledgment of Receipt of Materials
Printed/Typed Name Signature Month Day Year
Rabanco Transfer
2733 3rd Ave. S.
Seattle, WA 98101 206-652-8865
12. Discrepancy indication Space
Waste Disposal RRLC
13. Authorized Waste Disposal Site Owner or Operator: Certification of receipt of asbestos materials covered by this manifest
except as noted in item 12