NYC 9/11 Public Portal Document
09/1!3/01
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BULK SAMPLE DATA AND CHAIN OF Z
PROJECT INFORMATION CUSTODY FORM
tint Z 3a. ATC Project No.: da. ATC Project Man~q
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JTAT 024 HRS 072 HRS O OTHER
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BULK SAMPLE LOCATION 71k*' 3-gsor
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SPECIAL INSTRUCTIONS (CHECK ALL
THAT APPLY)
0 Stop Analysis at First PosOOve Sample in Ewa Cat
Homogenous Area. 0 Perform TEMMOB Analysis If Neoeaaary.
0 Fax Results To (Name)
at (Number)____________________________
0 Other
CHAIN O1F CUSTODY •
17. Re sch~di3~ 18. Date 19. Time of Method
20. Receives By 21. Date 22. Time of Submittal
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LABORATORY INFORMATION
24. Name and Signature: 25. 27. Comments (Lab)
24a. Analyzed By:
24b. rid By:
24c. OC BY:
NYC-WTC 000097911
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