NYC 9/11 Public Portal Document
Galson Request For Industrial Hygiene Analysis
Laboratories Company Name:
I 6601 Kirkville Road e r• c1( rl
•
P.O. Box 369
E. Syracuse, NY 13057 Site Name: S
Tel: (315) 437-7252 888-577-Labs (5227) -Project #:
Fax: (315) 437-0571 Sampled By: t° r't/~►
/ /
Send Report to: G~-
is 4 CAS-mac-/ 7_ Invoice to:
v
P/a,~-✓~ew 4' //~3 c/l/ 1
See
❑ Purchase order number
(or)
❑ Credit Card (type) Card # Exp Date
❑ Verbal Authorization
Standard Turn-Around Time OR ❑Rush: Date and Time Requested: / i am
~/ pm
0 Phone Results to: Phone # (S/t) — 5766 — 8d
D YJ ext.
❑ Fax Results to: Fax # (i7'b) -576 — CEO 93
❑ Email Results to:
Sample Medium Air Sample Analysis Method
Sample Identification Date Sampled Catalog # / Lot # Volume (liters)* Requested Reference
/// ' dl.4G / /8 0/ 3787 /a cAi 3ô S✓oC /Af( SSO
D5oo
?'-ICEf a- 7300
/// D4 _________
//prof o :G o! flI/c 3 GG T Soo
/ O7.¢ 37o°riE/ x 37 ØA
:
~l~ol a ,q/,Øiof ,~ C.Ef 3G Lem oo
///YO/O',46 350 oo
J~21eol Ac 37 Svoc #PAii 53 OC
/1l O( if .4G /(c< 3?/ F 3G 0 Geti I 7300
o 00
0 /`FAG !r 8' Ot PlF6/,o Jr 374 S SSo
I /if of / l ! O GF~9~ - Misr ~.51C 55a3
of 7RG l a/ ?4 G 73 00
/ i(70/ S /Ø
i - VVL 7'/S
l~ 8or l & c. - ~c;b
;
'For passive monitors please list time xposed in minutes.
Comments (Please list any known interferences present in sampling area):
Chain of Custody I Print Name ignature Date/Time
Relinquished by: ct i/l/Q/DI gr y
• Received by LAB. (37 . G lo=w
• Samples received after 3pm will be considered as next day's business.
LAB ORIGINAL
NYC-WTC 000108479
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