NYC 9/11 Public Portal Document
;PARTMENT OF ENVIRONMENTAL PROTECTION
Uk'AU OF ENVIRONMENTAL COMPLIANCE
SBESTOS AND LEAD CONTROL PROGRAM
9-17 JUNCTION BOULEVARD
CORONA, NY 11368
JDEL A. MIELE SRJ.E.
COMMISSIONER
BULK
ANALYSIS CHAIN OF CUSTODY
Incident No.: Date Sampled: O 2/24.ft 2
Premise: Ik Ld Ak P e/V STREET Bore:
Time: 3: atn
Inspector: /2. x}/1')/1w//4 ✓
Print Signature
Turnaround Time: Immediate I✓ I 24 Hours I I 48 Hours I I I Week I I
SAMPLE NUMBER DESCRIPTION _ I LOCATION SAMPLED LAB `[D
1. 202 X78 010 ; Y,.
2. ZOZ24 A078 "(1 i brol:S rf
3. 20 2 2.4/ M7g O12
4.2.0Z24 /,47C13 •~
s. 20 t /"7g 0I4 M
6. _ L4L 4 078 O/S
7. Zo2 2.4r A073 o/6 N
8. 2o2 ,4°78 0/7
9. 24'224',/,4o78 0 fe 6ib~ ! ^t. Qpv
10.
ANALYSIS REQUESTED: Asbestos PLM I I/ Asbestos TEM I I Lead I I
Time Accepted Bs Cotn cents
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IE► ACLP RE% MO
NYC-WTC 000112689
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