NYC 9/11 Public Portal Document
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BULKSAMPLE DATA AND CHAIN OF CUSTODY•FORM
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~' er't lazes-coot Mark Terjesen
3b. CGant Project No: 4D. Ghent Project Manager.
MTA Now York City Transitl 2a. AddT=
Office: of System Safety 4f4c O)4
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SPECIAL INSTRU~TION5 (GIIEGA w11_ 111AI Arri..1j1 - - -
O Stop Analysis at First Positive Sample In Each Homogenous Area. O Perform TEJWNOB Analysis if Necessary.
O Fax Results T. (Name) at (Number)
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23. Method
19. Time 20. Received By 21. Date 22. Time of Submittal
17. R tic3 18. Date
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LABO1R'ATORY 1NFOKMAI Mum
.25. Data 1 28 rma_J 27. Comments (Lab)
Name and Signature:
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24a.Afl1YedBY.
24b. Analyzed By
24c. QC: By:
NYC-WTC 000097912
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