15 JOHN STREET 1001217, 79/14

NYC 9/11 Public Portal Document

DEPARTMENT OF ENVIRONMENTAL PROTECTION. BUREAU OF ENVIRONMENTAL COMPLIANCE ASBESTOS AND LEAD CONTROL PROGRAM 59-17 JUNCTION BOULEVARD CORONA, NY 11368 1yf C ansa.A.t nL%sa,PL cosaIstala BULK ANALYSIS CHAIN OF CUSTODY

Incident No.: \4 C 0 e Date Sampled: I 20

Premise: s ' o - Si Boro:

Time: U ~aityptn

Inspector: C ' ..k t C yk%0wAG'D 1 Signature Print

Immediate I 24 Hours I I 48 Hours [ I 1 Week I I Turnaround Time: L '4:lAA.: , iti,:.:~;.~:.-..w77i: >;~.,:.m+5R"`;..wr..:'aa«ti:: :r~ x ,~v~ ~ .:~ .—~, _._...;:-at rv:.,u::... FLL 4eg~ n ry .I..$f . ~. r:..:i^.J.~a. 1ll- ~~;;n "~ iYY~' .~?.:NY~Awj I1P_w.'•:S: f1VWAjj{{Lf S I :;t f Z/ I~"O~ ^M't h

1. JL 0'113 t,H~ I~7tt~'ti~~a ~owvet• ; lt~~ (~/ ►o ~O t4 011

3. 1 Sto 13 '. 4.112 -1 1 I' '.. t► l £. t.1' G{ i ~. 1.. __ &?,a•11~ CE01S'' 0 I4vvl tt t~ A4 k) 6.

7. X0'11 S~{O% pu.1. Skt Oct ' It tt 54/ a'11 ~cS° " 8. x'11 Y4'S 0 • ~~6a • o►~~t 1 '` '` tt

9. . 0'i ~~ 6~ 1 • '. -. ~ ` '. 10. ~v'113 s~ ~~,O At6 U.' L,4 I 1ZsJ

Asbestos PLM [ I Asbestos TEM [ I Lead I I ANALYSIS REQUESTED:

Acrep*ed By ..Comments Date Time

1, am Print .

7/i 3 02 /2 : 3a sign rL L 2. am Print pm Sign

3. am Print Pm Sign

4. am Print pm Sign

5. am Print Pm Sign D6r A(:Lr aa,rxw

NYC-WTC 000094254