NYC 9/11 Public Portal Document
ILLCENVIRONMENTAL CONSULTANTS, INC.
CLIENT:
TECHNICIAN
PROJECT MANAGER
SAMPLE
1D
SAMPLE.#
FIELD #
LAB#
COLOR(S)
SAMPLE *
FIELD #
LAB #
COLOR(S)
SAMRLE#
LAB #
FIELD #
COLOR(S)
72
SAMPLE *
LAB#
FELD #
74
PALOR(S)
PLE #
FIELD#
LAB#
COLOR(S)
SAMPLE #
LAB#
FIELD #
COLOR(S)
DESCRIPTION/ LOCATION
Post-
Knckz!
LEODE
Bate WA
Pitiico
r Heal
Analysis Requested
PROJECT NUMBER
LAB BATCH NUMBER
SIGNATURE
SAMPLE INFORMATION
Sample Type
Paint
Soll
Wipe
Water
CHAIN OF CUSTODY LOG
DB-204Y
030341-1322
DATE 070
PAGEOFL
Size
RESULTS
Other
Content:
Unit
215
K9
605
V
RELINQUISHED BY:(print)
SIHiapi
RECEIVED BY:(printy MAdel/
RELINQUISHED BY:(print)
RECEIVED BY: (print)
ENTERED BY:(print)
CORRECTED BY (print)
CAB NAME:
ANALYZED B
ane
DATES TU OSTIME
QC BY
DATE
White Copy = Folder
Yellow Copy = Laboratory
Pink Coov - Project Manace
NYC-WTC_000132121
TECHNICIAN'S LOG
Türaround Time
•Verbal Results to
E 24 HRS
48 HRS
• Over 3 Days
OTHER
CHAIN OF CUSTODY
(sign)
11/05
(sign)
Tbale
(sign)
(sign)
(sign)
(sign)
LAB INFORMATION
METHODOLOGY
EPA SW846-3050/7420
EPA SW846-1979(4.1.3)/7420
EPA 68-02-4550
NAME
PHIPG/FAX#
DATE I / TIME
INSTRUMENT
Varian SpectrAA-250 Plus
• Air-Acetylene Flame
EJ Graphite Furnace
10*
15"!
V
NAME
ADDRESS
DATE /
DATE
5,03
3:10:03
Report to
TIME
TIME
COMMENTS:
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000132121Source: NYC Law Department, mirrored locally