NYC-WTC
000126063
JCB
CHAIN OF CUSTODY DOCUMENT
J.C. Broderíck & Associates
Bill To: J.C. Broderick & Associates
101•4 Colin Drive, Holbrook, NY 11741
Accounts Payable
631-419-0913 • Fax: 631-584-3395
101•4 Colin Drive, Holbrook, NY 11741
Expecte
10/19
Laboratory:
Emst <im)
Project Name: 52784
Project Manager & Kotlay:
Sampler (Signatare): -
Project Location: 115 wes Bicedway focf
Samplers Name (Print):
B1200212
Client Name: Andien Bld. CuP.
Project Number 2254
•6HR [12 HR 2324 HR [48HR [72HR [4 DAY [5 DAY [6-10
SAMPLE INFO
Project Phase
*A=AirB-Bulk W=Water I=Wipe
+-Time (min.)→,+L/min Liters
Analysis
Analysis Date
Sample ID
Date
Type
Sample Location / Description
Lab#
Start | Finish i Total
Start |Finishi Volume |
Method
MDL
s/mm 1s
Grey + Brown /Nek EntAce.
AN1723
ASBestos
ic/ré
ic/8
gret- Fibenglnss-keero iet wuír AaIZZY
Aspaters
jcey etsis lVorth side Poof
AJ172I
I/m
ASAstos
NYC 9/11
Public Portal Document
10
11
12
13
14
15
Relinquished by (Signature):
Relinquished by (Signature):
Date rix
Time
Date
Time
Printed Name & Agent:
Printed Name & Agent:
Relinquished by (Signature):
Date
Printed Name & Agent:
Time
Date (0-19 Printed Name
& Agent:
Time2us
K. Iuglio
Comments & Special Instructions
Fax Results to 631-584-3395
White - Laboratory
Yellow - Office
Pink - Field
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000126063Source: NYC Law Department, mirrored locally