NYC 9/11 Public Portal Document
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ASSOCIATES INC. / S'?- •
BULK SAMPLE DATA A114D yq c'
PROJECT INFORMATION CHAIH OF CUSTODY FORM
1, cIlcn
2 Pro}eet me: 3a. ATC P
c ` 4a. ATO plplso
MTA Mew York City Transit/ y M C 16266-0OOs N13nager,
2a. Prnleot Ade~ress: Mark Te esen
Office of System Safety 3d' t 4b. Client
6.Oata sect Manager
6. Building Name:
7. Sampling Hteas O 24 HRS O 72 HRS O OTHER {
O 6 HRS O 48 FIRS O NORMAL
13 L SAMPLE LOCATION
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l4es No. D No. The Su~pio leovCan t
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FlDOC Sarr~pla Co004 tss W, iY1 X1
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LA- 7'81-
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SPECIAL INSTRUCTIONS (CHECK ALL
THAT APPLY)
D Stop Analyt.Is at First Positive Sample In
Each Homogenous Area, 0 Perform TEMVNOB Analysis if Necessary.
Fax Results To (Name) e- R t- /f il-M it & A4/ at (Number 1 ) Z _3 3S
0 Other _
CHAIN OF CUSTODY
17. Relinquished y 18. Date 19. Time 2Q. Received 8Y 23• ethod
!~ 21. Date 22. TimQ of Sut~mittai
II.
lit.
LABORATORY INFORMATION
24, Name and Signature:
24a. Analyred y: Date j26TTme P7. Comments (Lab)
24b. Maiyzed By:
24c. QC By:
NYC-WTC 000097913
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