NYC 9/11 Public Portal Document
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`DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF ENVIRONMENTAL COMPLIANCE
ASBESTOS AND LEAD CONTROL PROGRAM
59-17 JUNCTION BOULEVARD DUpi ~j'f}`'E
CORONA, NY 11368 -. ` ICA
JOEL. A. MIELE, SR_P.E. r
COMMISSIONER
BULK
ANALYSIS CHAIN OF CUSTODY
Incident No.: Date Sampled: /2 3, 2 '2
Premise: 96 GH11-M8ER S7RE7 Boro• m4'" 1 1 A
Time: /1:.3 S (9/pm
inspector: R#/rf /YLO I4
Print Signature
Turnaround Time: Immediate (✓I 24 Hours ( I 48 Hours I J I Week I I
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1 c> {• LAB ID. . >5 2?
I. 20 2 23 *78' 0/9 D;r /:. R,Q St a 4'41
2. 2-02- 23 11078 02-0 r AWd (AJ'e srf a f
3. 202-23 /-1078 O2 / k,niii D i%r Nam 4'e* 2
4. 20223 /-'0 78 rb s -i rf -
5. 2oZ23 AC78023 i ,s Z~Yf- g
6. .2.02 23 ,*z,7 - Qom- i brt uS Di r1- ka% Gwifey f5
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8. ,2.02 2-3 A07?026 ' (7W,rs it c,srJ~-- 4.Lfr4 f
9. 2.0223 /4Q71r 027 4 2a~a S, cc Gam'. C41
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ANALYSIS REQUESTED: Asbestos PLM If) Asbestos TEM I ( Lead
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Date Time I Aeceted Bv ;<osniet tts
am Print
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Sign ~/ ni •
2. am Print
pm
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3. am Print
pm
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4. am Print
pm
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S. am Print
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WEEP I(LP RE:% 5ii i
NYC-WTC 000122201
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