NYC 9/11 Public Portal Document
MAR. 30, 2003 7:59PM JLC ENVIRONMENTAL K. 032 P. 2
JLC ENVIRONMENTAL CONSULTANTS, INC. CHAIN OF CUSTODY LOG
CLIENT: 1~' (tb €n IJECT NUMBER: _ C
L~1 aw4-t. St , BATCH NUMBER:
TECHNICIAN; -1{ -r LOc'-'31Lij SIGNATU DATE: ~77 /2j
PROJECT MANAGES:
PAGE OF
I
Sample Type Size RESULTS
SAMPLE DESCRIPTION / LOCATION
I.D. Paint Soil wipe Water Other Content Unit
SAMPEf FIELD #
L ( 2 .y. gl~
'a'
MP E I FIELD*
_ tt :....
nnn AA ~}
LABalVli3L~, 3 !
SAMP FIELD e
LAB
..../.....i..t
f
:......... Ifit,
OLOR(S) Ir
W ti~ ti ,
SAMPLE #
LAB#
J FIELD N
.................................................................
COLOR(S)
SAMPLE FIELD S
.......,
LAB >x
........................ . ................................ . .. ............. ,
COLOR(S)
SAMPLE # FIELD #
...............................................................................
COLOR(S)
Analysis Requested Turnaround ime Verbal Results to Report to
24 HRS NAME NAME
❑ 48 HRS pNlpofFAX# ADDRESS:
❑ Over 3 Days DATE / / TIME
OTHE DATE / / TIME
DATE TIME
RELINQUISHED BY:(print) (sign) 3'
RECEIVED BY:(print (sign
RELINQUISHED BY:(print) (sign)
RECEIVED Y:(print) (sign)—
ENTERED 8Y(print) (sign) .J . ......../......
CORRECTED BY:(print) (sign) / l~
LAS NAME: 1 M TH000LOGY INSTRUMENT COMMENTS:
ANALYZ4J1 EPA SW846.305017420 Varian SpectiM.250 Plus
DATE / tME: ❑ EPA SW846-1979(4.1.3)!7420 0 Air-Acetylene Flame
QC BY: DATE: ❑ EPA 88.02-4550. ❑ Graphite Furnace
LP il. .nnv = Pnbf'r
YCllow Copy • Lsoor lery
Pink Cepy s Proloaf Manager
NYC-WTC 000101148
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