NYC 9/11 Public Portal Document
Date:. (0 - 1- & 1 New York City Department of Environmental Protection
(Y). D Kensico Laboratory
Dav: 11 AQCA General Chain' of Custody Form
# OF BOTTLES COLLECTED
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6 - 15 520 *
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SITE LOG NUMBER TIME jslr . . . , m
AATC =
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COMMENTS:
-0e-E--=-- ------ € emplous. Dateime dez RECEIVEO BY MICRO: RECFIVED BY INSTRUMENTS
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by Sample #s:
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RECEIVED BY-GH5*B*TY lo C, Dol RECEIVED BY MICRO
(DateTime) (Date’Time;
AeUR Date/Time RECEIVED BY INSTRUMENTS:
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/ s
Sa(Date/Time) (Datefime) (Date Time;
Reli, by: Sample Is: Date/Time RECEIVED BY CHEMISTRY; RECEIVED BY MICRO. RECEIVED BY INSTRUMENTS:
(Date/Time) (Date/Time) * (Data/Time)
“All samples collected, preserved, and transported according to Division SOP guidelines.
NYC-WTC_000027066
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