NYC-WTC_000103919
TESTWELL I. AB BOR
47 Hudson Street
Client:
-@ -~ @ e ‘@e
ilenaiuns INC.
g, N.Y. 10562 ‘TIL (914) 944-2570 FAX (914) 941-4154
oune Lied Legs, £48
£
* @ @ a
Bulk Sample Data Chain of Custody Page é. of
Project # MEO OCP He “Le
Project Site:
LLEAOAC bej0d
Date: G - Y -O£
Project Address: 24
Report to:
ewe Veet. A120 VoCke.
406/38 FEL SAL
Inspector:
T
Sy
Signature
Name
Date Analyzed:
Date Analyzed:
Company /, ‘ Tel/Fax
z/o f Analyst: (PLM) _¥ @ VE &
Analyst: (TEM)
NYC 9/11 Public Portal Document -
FIELD
SAMPLE # | FLOOR
AREA {GROUP | ITEM
CTIONAL
DESCRIPTION
LAYERED?
Y/N
TYPE OF
REPAIR
FRIABLE = F
NOB =N
3}
EE YUE L
Wes OY FELOL.
a wn Per Wee
iS
~ |Geny
I
SUL
2
'
Ny
31
budld
4,
—
7
wfenaamarcey”
Pb
a) [wr | —
>} boy} sy
sa
=.
5689
BE
HAYS] SS] RB] S
y
NO] ot
Ys
GBD
of
3S
B62.
62
cz
Vy V/ AD __ |B g 73
onan
(a
Pn anened tam |
PAN
Y,
Dari:
oyo9
Dati: TIME:
Qi -OW
Time:
LL
R&LINQUISHED BY (SIGNATUR
Dare: TIMES RE FCEIVED BY (SIGNATURE): DATE:
TIME:
Frinble = NYS DOI 198
COMMENTS:
NOB = NYSDOH 198.4
Turnaround Time: 8HR 24HR 48HR 72HR
OTHER: (must be dated on time)
Stop at 1st Positive per homogeneous nator ve) or No
Hold for TEM Confirmation? Yes or No
WHITE: LAB YELLOW: SITE/TECH
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000103919Source: NYC Law Department, mirrored locally