NYC 9/11 Public Portal Document
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF ENVIRONMENTAL COMPLIANCE
ASBESTOS AND LEAD CONTROL PROGRAM
9-17 JUNCTION BOULEVARD
CORONA, NY 11368
JOEL A. MILL SRJ.L
COMMISSIONER
BULK
ANALYSIS CHAIN OF CUSTODY
laeident No.: Date Sampled: 02 OZ
Premise: 20 (,4J4RIZEN s TREEr' Boro:_lh~~/~!J fTftr/
Time: 3: 2S ame
Inspector. 2. R4sri/).W#,'~✓
Print Signature
Turnaround Time: Immediate I J 24 Hours I I 48 Hours I ( 1 Week I I
SAMPLE NUMBER DESCRIPTION I I LOCATION SAMPLED LAB :lb
1.20 Z 40 78 O/ Ffbrour QiY4- o
2. 2OL 2. 1.4-07.0 02-.0 It Ir
ri
3. 202 ,447802/ , Ir
4. Zp2 Aoy8022 rr Ir n
S. ZOL At'78 ri If rf
6. 20 2 4>7g0 rr rr rr
~. 2O2 M'7 o2S
8. 202 78026 rr ri
9. 2021' x}078 027 cl b)- u o
10.
ANALYSIS REQUESTED: Asbestos PLM 1 ✓ Asbestos TEM I I Lead I I
Date Time Acce Br Comments
1. am Print
pm
Sign
2. am Print
pm
Sign
3. am Print
pm
Sign
4. am Print
pm
Sign
5. am Print
pm
Sign
NYC-WTC 000112700
OCR can misread numbers and units. Confirm readings against the page image before using them.