NYC 9/11 Public Portal Document
PAGE 02/03
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09/29/2001 16:02 ATC ASSOCIATES
P11
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VAMASMATESWC.
Chain of Custody .PMRONMARA rrcHl cAIANOMAt!R14SNOFi$T r'i
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SsmpM Numbsr(s)
jUsCiu1iudBV L/{ Date Cauected
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Type of Srnp s (drde tine►
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Type d Ar*yser )
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round Time (Prease ensure laboratwy can accommodate the request before sending: thde
2 W. 4 hr. 6 hr. 12 hr. 24 hr. 46 hr. 121w. 3-5d3y$
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❑ -StardwdReoonTumvoundAF..,z,~narkina,faxel.-.-.-.-.-.-.-.-.-.-.-.-.-.-_.-.-.-.-..,_..._._.
❑ Plow Yefepllorte results t
Telephone i by on (Dale)
(Time)
❑ : Please Fax results to
Fa: I by — on
(Date)
Dale)
❑ AddiSonallnrtMclions
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Number of samples GondtbOn of Samples ❑ AA:cepl 0 Relecl
Sample Integrity (To be filled out by laboratory only)
Lab Comments .
AddiL0nat Cornet r . _. _... . ..
NYC-WTC 000096244
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