NYC 9/11 Public Portal Document
` fEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF ENVIRONMENTAL COMPLIANCE
ASBESTOS AND LEAD CONTROL PROGRAM
59-17 JUNCTION BOULEVARD DU ~L
CORONA, NY 11368
JOEL A. MIELE. SR_P.E.
COMMISSIONER
LIL,LTE
BULK
ANALYSIS CHAIN OF CUSTODY
Incident No.: Date Sampled: 2 3 ~Z -
Premise: 96 GHA-mi3ER ≤7RE7 Boro• m4"' d4' 97
Time: // 35 (9 /pm
Inspector: * R#/YJ /YL0 H4
Print Signature
Turnaround Time: Immediate t 1 24 Hours ( I 48 Hours I J I Week I I
.'-f3Kifft.7r :N• ri1PCiJ~ ..:.' .. .. :.~ +iRY~a7CRZi:;i: Q1\: .:.:.. . .. . .::: ? t 3. A IONSAMJIL 2if.... . .... . .. ' "r. .. lw. .. LAB ':. JD• . .F.i.. .i., :..
1. 20223 fio1' 0/9 !D op Sa c 2.4
'
2. 2- 23 X078 020 r
hrwc
3. 20 2-2-3 /ao7S o2 I Nclrt 'e*
4. 20223 4o7g i brows -i r!- 3
5. 2.oz.2.3 Aa7T 023 a
6. 2,022-3 4 ,78. 0 24 i bra-us Di r/- 1pa: (s'w.//ey
7. 20223 /~7,Q c2 ' EMI,~s j t rf- t~ 0,,;64 f-
8. 20 .2-23 JA-°7 o 2 c (ors r ri Sutc-- te -~ f
9. 2.0223 /4a71027 ~r br D"I r- 2: _ ~,, e~-• cN
Io.
ANALYSIS REQUESTED: Asbestos PLM I✓, Asbestos TEM ( Lead I
Date 'I~#~tr By ' a ntc;xts
1. Print
0367
m f
Sign t ~/ n7 •
2. am Print
pm
Sign
3. am Print
pm
Sign
4. am Print
pm
Sign
5. am Print
pm
Sign
nEP I&LP RI:' 5'
NYC-WTC 000122201
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