NYC-WTC_000103917
TESTWELL LABORATORIES, INC.
47 Hudson Street, Ossining, N.Y. 10562
Client:
Pours, Lit Lee, £48
TEL (914) 944-2570 FAX (914) 941-4154
weer
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Bulk Sample Data Chain of Custody Page
MEO -O2A4L,
Project #:
Project Site: _. Mitkenpiont bit
Date: G- A -f
Inspector: 60 (Zh QL, LE SOME
Project Address: Met Vokt. Z AiO Voeke.
Report to:
4 bag
Signature:
Company
Analyst: (PLM)
Name
Date Analyzed:
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Analyst: (TEM)
Date Analyzed:
J, / Z pb Tel/Fax
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TYPEOF (c27_PLM?
FIELD NCTIONAL
SAMPLE # | FLOOR AREA |GROUP | ITEM | \
DESCRIPTION
LAYERED?
Y/N
FRIABLE = F
NOB=N | COLOR REPAIR |. NUMBER’:| .NUMBER 2| (58)
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Time:
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RELINQUISHE! (SIGNATURE ATE ‘
RECEIVED BY (SIGNATURE):
Dari:
‘TIME:
Friable = NYS DOU 198.1 "NOB = NYSDOT 198.4
COMMENTS: J?
Turnaround Time: 8HR 24HR 48HR 72HR
OTHER: ! (must be dated on time)
Stop at 1st Positive per homogeneous waiaian 05) or No
Hold for TEM Confirmation? Yes or No
WHITE: LAB YELLOW: SITE/TECH
NYC 9/11 Public Portal Document
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NYC-WTC_000103917Source: NYC Law Department, mirrored locally