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NYC-WTC_000103909
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TESTWELL LABORATORY INC. Bulk Sample Data Chain of Custody Page 2 of
47 Hudson Street, Ossining, N.Y. 10562 TEL (914) 944-2570 FAX (914) 941-4154
MEO -~O02LL,
UMASS Liv LE. ALE LYE Project #:
Mite EM “AL biiod Date: G - 2 é -OSf
510 Vow. Mie Yorks. inspector, OGLIS. CLL SAE
Report to: Signature: an oe
_ Name te mE ea - Cee 6
Date Analyzed: YW Analyst: (PLM) Lek.
7 ;
Date Analyzed: Analyst: CPI) _
; -: LAB USE ONLY 4; oe
Bae
FIELD FUNCTIONAL LAYERED? | FRIABLE = F TYPE OF OE “PLM TEM :|. ae
SAMPLE # | FLOOR AREA |GROUP | ITEM DESCRIPTION Y/N NOB = N COLOR REPAIR “NUMBER - ~ NUMBER = 1¢-( : ie
| |S2 bubons Z omen Ew pl | FE | Gray Boye.
Ip PU ROL
A |
| a \ | \ Rors —
13 BI Seo S
| | | Wwe | 2
(C i) bus 109 N/ 3 | Zor
IG |S Be 6|\( yor) | —
: 1? | Bucns
; a Ma Pale | a pore ~
YarT) wl 4 V V Ny V IA ory a
“IR we Dares Tim: SIGNATURE): Dari | Timi: Turnaround Time: 8HR 24HR 48HR 72HR
° > Q\-2$-6 4
AG; Ors | OTHER: (naust be dated on time)
RELINQUISHED BY (SIC Darn: Time: {vs)
Client:
Project Site:
Project Address: Neto
| Pory a
GOT
fory i
Recuven py (sionaturn): 7 | Bare: | Time: Stop at ist Positive per homogeneous material? Yes Jor No
Hold for TEM Confirmation? Yes or No
WHITE: LAB YELLOW: SITE/TECH
Friable = NYS DOH 198.1 NOB = NYSDOH! 198.4
COMMENTS:
4
NYC 9/11 Public Portal Document
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NYC-WTC_000103909Source: NYC Law Department, mirrored locally