NYC-WTC_000103901
aa e ; @
TESTWELL
47 Hudson Street,
Client:
ORIES, INC.
Y. 10562 = TEL (914) 944-2570 FAX (914) 941-4154
LL
OM = Are POU
Project Site:
Project Address:
Te
Mei EAN
Report to: Mice D
EWE Fan HO 3592-6993
Name
nan ol as OF er
Date Analyzed: Gfel Z/
Date Analyzed: J
Analyst: (PLM)
Analyst: (TEM)
e @ ® :
Bulk Sample Data Chain of Custody Page [ of
LiPt -O8. SHH
Project #:
qg LG - -O/
Date:
Inspector:
Signature:
LAB USE ONLY
FIELD
SAMPLE # [FLOOR |
LAYERED?
GROUP { ITEM DESCRIPTION |
FRIABLE = F
NOB = N
TYPE OF
REPAIR
_O1PLM
NUMBER
TEM
NUMBER
of | ff
Y/N
Proce WiNEws
(| DEBS OO FLOR A/
E
2973
02
2| DEALS gn Rope
/
| 2013
2 [Dust ov Forwiveg
7544
Bi frs OL Fen hee
| 2s
=
a
Dust BL) FURAN:
s!
7646
Ty
Ec ounnks
IRN
|
l Ba
2 \ Cone lor
|
J Deeers chy Ploe.
7847
“ers wit Dou
( g1e CN FLOOTA:
7846
Du l 10S
Bee
‘
ell 2 Dust 60 rae Menke.
784) ~
Zi
OY
ov
Ob
07
03
om
ASE,
we
pe IV to tet WO
| Fatt
i)
13
OH oy)
All bur wy yh d
—
—a-
78S 1
DATE:
AK
RECEIVED BY (SIGNATURE): Date: | TIME:
RELINQUISHED BY (SIGNATURE)
307
Date: | Time:
DATE: TIME: Ty BY (SIGNATURE):
fat fo
Ji304m
Friable = NYS DOH 198.1
COMMENTS:
NOB = NYSDOH [98.44
OTHER
Turnaround Time:
48HR 72HR
ann) 24HR
: e dated on time)
Stop at 1st Positive per homogeneous material? {Yes /or No
Hold for TEM Confirmation? Yes or No
WHITE: LAB
YELLOW: SITE/TECH
NYC 9/11 Public Portal Document
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000103901Source: NYC Law Department, mirrored locally