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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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NYC 9/11 Public Portal Document L copy for your records. The white copy will be returned with your sport Please retain pink

Galson Request For Industrial Hygiene Analysis I • Laboratories eool lorkvllle Road P.O. Box 388 Company Name: Site Name: ed f 16 c vt c 4 eb

I E. Syracuse. NY 13057 TeL (316) 437.7262 888.6774-abs (6227) Sampled By: ~' Fax 316 4370671 tS .~ /~ Project #-.

tom• Til.G Invoice to: ~ ~ Send Report to: S roc 7 __

❑ Purchase order number (or) Exp Date ❑ Credit Card (type) Card. # ❑ Verbal Authorization am Standard Tum•Around Time OR ❑ Rush: Date and Time Requested: pm phone ie (S/) g g 5" t ❑ Phone Results to:

❑ Fax Results to: Fax l (3 ) - S76 - Oo 9 3 ❑ Email Results to: Sample Medium Air Sample Analysis Method Sample Identification Date Sampled Catalo # / Lot A Volume Iltera • Requested Reference

So 1rc t alo D s Sd C- 00 I80 /C Lr '190 37ftcg1co.8 3pQ it Sc' 1 17 S!lc y~o 7 i.o X ss 6 pG ''`3, r •e o • I 40 B 2 I go is 7: of ' SSo II OI 20uL f7Wvry -7 1itcrI/?yIrir 6GC \J

•For passive monitors please not time exposed In minutes.

Comments (Please list any known interferenoee present In sampling area:

Chats of Custody god 500 I. . / Print Name t1J1G D ;.• Signature nL iretet~ebeAT TA Date/Time n?'Ann

NYC-WTC 000108483

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NYC-WTC_000108483Source: NYC Law Department, mirrored locally

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Record documenting the transfer and custody of air samples from Building #100 at 345 South End Avenue collected on October 22, 2001.

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