NYC 9/11 Public Portal Document
Galson Request For Industrial Hygiene Analysis
Laboratories / L
6601 Kirkvitle Road Company Name:
C6 ~ C/~ ,
" E. Syracuse, NY 13057 Site Name: 2-/v' /50 styee
Tel: (315) 437-7252 888-577-Labs (5227) Sampled By: AC~~~~,' 1li
Fax: 311/5 4337-0571 1 Project #:
[[ 1 .)
Send Report to: 4114 ,E' cA c sc/ J Invoice to:
v ea
%
/t4 ' i i Qo 3
s f y e /4 r +.o ~/c .
❑ Purchase order number
(or)
❑ Credit Card (type) Card # Exp Date
❑ Verbal Authorization
Standard Turn-Around Time OR ❑Rush: Date and Time Requested: / / am
pm
❑ Phone Results to: Phone # cS/h - X76 - YV5" ext.
•
❑ Fax Results to: Fax # (s/~ - s76- C 43
❑ Email Results to:
Sampled Sample Medium Air Sample Analysis Method
Sample Identification Date Catalog # / Lot # Volume (liters)' Requested Reference
I o o1_ It/IS/O VL us/-
tI iotoP-5Ti'i1 t r ig 0 37 CEP o,S _ Lea 7 300
• g 3 T - (l(s/0 37PIf5v i 3O St/c./P//4 _SUS
Mto _ 11 f8 0(` :: ,w, cti'/ 2 V O`C' - /S-71
i t180a~ iM (r//8ai~ For;s, :G[6 Pc 1 sso3.
•
■ 1I I I O STi~1
~~ l~~/o
■ igo S rM ~t VG Tb o
( 180!0 9 S M o / 22; p LPQ
• ( Iol 10 3Tt4 I o 37& J O SV S50(,
1 ii oi i s (//Sloe C-Ff or;5t
co l3 S lc 8 F, r Ply t, .
(f/i8/o1 3~~rf~ r.t/~r,¢~ :
t
• 3 Voc/PA-f4 5sa
31 aNK f(l s /o V C~ •1'r vs_ p~'oo
B(aN ►t(r81a( ; I file P 'M
cc,v ~, ~c%$log PC Ssd3
'For passive monitors please list time exposed in minutes.
Comments (Please list any known interferences present in sampling area):
Chain of Custody Print Name I Signature Date/Time
Relinquished by: S't ri'eti4/%>_ t' ~ C~ (g. Y
. Received by LAB. (Y1 , KtV /1/JO/c'!
■ Samples received after 3pm will be considered as next day's business.
LAB ORIGINAL
NYC-WTC 000108488
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