NYC-WTC_000103922
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Client:
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TESTWELL LAD BO
47 Hudson Street, Ossining, N.Y. 10562
RATORIES, INC.
TEL (914) 944-2570 FAX (914) 941-4154
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Project Site:
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Project Address: 244
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Report to:
Date Analyzed:
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Company Tel/Fax
Analyst: (PLM)
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Date Analyzed:
Analyst: (TEM)
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NYC 9/11 Public Portal Document
Bulk Sample Data Chain of Custody Page
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Project #:
Signature:
FIELD
UNCTIONAL
SAMPLE # | FLOOR
AREA GROUP | ITEM DESCRIPTION
LAYERED?
Y/N
FRIABLE = F
NOB =N
TYPE OF
REPAIR
NUMBER | NUMBER -| ‘3 (725)%
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MADD PURMOW CE£E
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Dart:
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RECEIVED BY (SIGNATURE):
9. Pye
lap. TIME:
Q 39-0
TIME:
st)
RELINQUISI
or Wa
RECEIVED BY (SIGNATURE): Darr:
BAY IMI:
TIME:
Friable = NYS DOH 198
COMMENTS:
t
NOB = NYSDOI! 198.4
Turnaround Time:
OTHER
24HR 48HR ‘72HR
8HR
: (must be dated on time)
Stop at 1st Positive per homogeneous mata 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_000103922Source: NYC Law Department, mirrored locally