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345 CHAMBERS STREET; Block: 16; Stuyvesant HS

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000106890–000107152
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Scanned page image, NYC-WTC_000106893
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NYC 9/11 Public Portal Document

TAYLOR ENVIRONMENTAL GROUP, INC. 516.358-2955 130 JERICHO TPKE.. FLORAL PARK, NY 1 1001 Fax 516.358•(780

LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT SAMPLER ISIGNATU DATE TIT.IE SAMPLE(SI CLIENT NAME/ADDRESS S CONTACT: von\ — I [ lO . I SEALED Qtw ~ 1 \ SATr CORRECT •= ES NO S Utq~t~ D cir 'i CONTAINER(S)

PROJECT LOCATION: PROJECT rY ,,` MATRIX (CIRCLE ONE): pE PAINT SOIL OTHER

SAMPLE INFORMATION: AREA(FTII SURFACE MATERIAL TABRESTILT SAMPLE N LOCATION WOOD METAL BRICK OTHER LABORATORY N USG S c',

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TURNAROUNDRFLIUIREb: COMMENTS / INSTRUCTIONS -\ \L ~(J 1 V o ~ ~ NORMAL 0 STAT ❑ BY I I

PRINTED NAME EC .i/ED BY ISIG~ URE) DATE PRINTED NAME RELI QUISI IE( BY ISIGNATUREI UATE ' '

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IIME I TIME

NYC-WTC 000106893

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NYC-WTC_000106893Source: NYC Law Department, mirrored locally

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