Lead clearance sampling chain of custody, 250 Broadway, Sept 2001

NYC 9/11 Public Portal Document

i 103 NEW YORK CITY HOUSING AUTHORITY LEAD DETECTION AND ABATEMENT UNIT DUST WIPE SAMPLE CHAIN OF CUSTODY Contract # '~ --per. !e:'`f?/.----.. Date ..` ...L C 1• .(...Inspector's NameCC.•• Y ...j 1 ...--1Cee#T •••-••-•• Release # . ............................ Development -• CG~?r G-.:.--. 1....0 -----••_.._•••-•----•••-•..-......•_- Fax to (718) 707-5255: Attn: Raphael Flech Address •.•••._____-_•_••••-•-••-•••-• ............. -•---•-•, 2 Report/Bills must be submitted to: Apartment/Facility Type -•---•••••-••'•••-•••--"'--' NYCHA-Technical Services-LDAU s ........... .............. SH #••- EDP #,• ~ -_-. Clearance Category:.--..I-.--.____. 23-0249 Avenue, 5`h floor LDAU Ticket #/Note: Long Island City, NY 11101 Clearance Categories: 5. Soil Work 1. Interior Treatment without Containment 3. Exterior Work On Painted Surfaces 4. Routine Maintenance 6. 504 Apartment 2. Interior Treatment with Containment SAMPLE AREA LAB SURFACE TYPE DIMENSIONS 2 RESULT SAMPLE ID ROOM EQUIVALENT (f) (Month-Date-Initials-No.) (in inches) L ~ FL WS WW ST SL -- -- J !<- O! LANK Other. FL l 2 r SWWSTSL !ZX / L o ~ -- - - --~2 FL t Z -- . w - 12 v o Other ,~Es t-o~

l - o3 FL (2 S " r 2v 9q ~ Z~ FLWS WWST S Other v~str ~ S7 r 2, X fZ I __ ~~ ~- FL WS f 2 X f Zi Q FL 1Z S v✓ 1 ~-1 other .. I I I Ot WS WW ST SL 2 X 12 f L. oflFL I l 10( NW ocher p65(r M/ S SL FL WS WW/T r2 X/Z -- ► -- 06 L I [ S I/Il - ! I S other v~ 7~~ WS WW ST SL ZX(L __ -- -- FC /0-- , 6e4 fi--41-- P~hT other FL WS WW ST SL — other. aWP Ill X /2 J -- `l FL q" W ' - !r` , roily FL WS WW ST SL XjZ -- ? -- 0y FL 6 - N E ' ~~030 other: we I FL WS WW ST SL -- 10 rL 3 - N w - -- 3113 other I 7- / z sk 7VP -- -- - FL 3- SF- 3o Q 8 sewsf`Esfr aL i Z X/ z i !`( Z XtZ ~✓ `J -- -- ~' -- ti L - N w- 2o6 q OtherJs 7 X FL WS WW ST SL -- Other. I -~r FL WS WW ST SL -- -- -- Other. W ST SL X -- -- -- Other FL WS WW ST SL

FL WS WWS —+S X -- - Other. FL WS WW ST SL X -- — -- Other. LANDIS =WINDOW WELL; ST = STAIRTREAD; SL = STAIR ABBREVIATIONS: FL = FLOOR; WS aa}'INDOWSW SILL; WW Date: 6:1...................... G1 Time: l~''~'(~OG-.. A Sampled BY~ By J r ..... vl.. ~' -•'.F/.••••••• A Date: - ......q...~. ~.....Time: .............. Relinquished By: •.M/ A'tt .... ..2 .................................................. Date: -_.9 •••••-•.-_/9_ • /••._ -..Time: .............. A Received By: a :. ` . /........._..Time:: .............. ~ ._..... Date: ............1..........- ...................................... Analyzed By: ............ Total number of samples on this page Rptmirrd Turnaround Time (TAT) is . ... hrs NYC-WTC 000106070