NYC 9/11 Public Portal Document
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Lead Bulk Sample Data Sheet/ C.O.C. ($a~L)
Colden Corporation Project 11t'o: 02.ta4 Client: Battery Park City Parks Conservancy
Project Name: Wc.Sk- 1lOvr i p-% %
Date of Sa'tple Collection: + ~ Samples Collected By: 1 obart R. Van Deusen
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Samvte I.D.: SamQle Locatiots: terial: L b* Az~ y4
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eni Tavuice to: Colden 100•N. 17 St., 9 , Philadelphia, PA 19103
Pax Results to Rye VanD • IL.. at (20S) 692-6091 O Faz .results to: Rich at (313)+1 11';
Laboratory Name: $ ?ash SAMPLE TAT: e S Questions cuL:
Samples Relinquished to Lab bys 7 Tom. Y~11~~ 8n
Date: J2.O 7 (Film Name) )
Samples Received at b by: > ' 2J< P& f~tl`• } .
Date: V (Pant ame) (Signature)
bT'd 82:60 z00z-9z—adW -
NYC-WTC 000130940
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