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Chain of custody form for indoor air quality survey at

Machine-extracted title · confidence 95%

Documentation tracking the collection and handling of samples during an air quality survey at the specified building.

NYC-WTC_000108401–000108573

Folder label: “45 JOHN STREET; Block: 78 Lot: 28 BIN: 1001199 1-5 Dutch Street

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Scanned page image, NYC-WTC_000108557
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NYC 9/11 Public Portal Document

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Requested by Client : 11/15/01 Date Prep Sent : Client Needs Prep : 11/16/01 Client Name : CA Rich Consultants Ship Prep on : 11/15/01 PO#/Project # . Account # : 1471S Client Project / Task-Dept :

Prep Address: * Bill Prep To Mr. Steve Malinowski (Preps under $ 20.00 will be billed CA Rich Consultants with sample results) 17 DuPont Street Plainview, NY 11803

I Ship via : UPS Red Noon Charge to: Client Contact by: Nancy Ackerman

Preparations Required I Sampling Method, CHARGES SOP #, Lot # Analyte(s) Unit Final QTY, Media .w.caY;y{,Y ~ :~+y~•~~~+~~:~?:;:juKs{y4;.0h>:.b,.•~~`:{,;:';} ' <;;'>;'> ,`~{; :%:5:2::5:it • «? ~• ~~•X ;<:'<< { ::>:;: :: <,:.• «; High Flow Pump ® 2.00 LPM ofq <, 0 .0 0 s. .~•~{ `'.; r•~•':>~. : (NIOSH 5506) j''•

High Flow Pump A 2 .00 LPM 0.00 • Pk R (PVC) ~ . «c3 cua'ry g ~>~•. •}' •. •, :fir' ~,~>;:.~{ LOW FLOW PUMP ® 0.200 LPM (HG) ~` 0 .00

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I • t#1{ { ~' z i?~•~:• VOC s .~ 0. 00 mini-can O4 O;. 0.00._. X344 hour Regulator for .. ...J.{C ..... i:MSS:>YYFn}ihG 2S?•r>.:! >: ..

s€ ;t< : h PAH : 0.00 37mm teflon filter(SKC 225-17-07; use Cutout s4gasket , tin foil squares '`

Chain of Custody: (x) Yes [ l No Shipping Charge = $ 35.00: Copy of Method ? [I Yes [] No * Total Charges = $ 35.00" I * Orders exceeding $ 20.00 will be billed separately. verified. Shipping costs are an estimate and are subject to change once actual cost is IvAc/1 00 i Comments/Special Instructions

Anticipated Date of Sample Delivery : Turnaround : Standard Fee Schedule : 2001 Quote # :

Distribute to : GC LC MET WET Reviewed By : Date

Galson laboratories. 6601 Kirkville Road. East Syracuse. New York 13057 315-432-5227

NYC-WTC 000108557

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NYC-WTC_000108557Source: NYC Law Department, mirrored locally

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