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← Document results/DEP Box 38/45 JOHN STREET; Block: 78 Lot: 28 BIN: 1001199 1-5 Dutch Street
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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_000108479
OCR text

OCR status: ok · source: pdftotext

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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NYC-WTC_000108479Source: NYC Law Department, mirrored locally

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