E-Mails Hotline M. Gilsenan

NYC 9/11 Public Portal Document

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Background sampling and analysis will consist of the following:

Air samples collected from small pumps running for an eight-hour time period in the Residence;

Low suction vacuum samples collected from carpets, fabric furniture, and/or drapes, in living areas;

Wipe samples collected from horizontal surfaces of tables, counters, bare floors, walls and ceilings;

Samples collected from individual air conditioning/heater units.

EPA will analyze each of the samples collected for asbestos and lead. Wipe samples will also be analyzed for dioxins, polyaromatic hydrocarbons (PAHs), silica, calcite, gypsum, man-made fibers (such as fibrous glass), and total dust. Indoor air samples will also be analyzed for silica, calcite, gypsum, and man-made fibers (such as fibrous glass). Upon completion of the analyses, EPA will distribute the individual sampling results to each volunteer.

I understand that I, or my authorized representative, must be present during the sampling and may observe the activities being performed in the Residence, and I, or my authorized representative, agree to comply with instructions provided by EPA.

This written permission is given voluntarily with knowledge of the right to refuse and without threats or promises of any kind.

I certify that I am the owner or tenant of the Residence, and I am authorized to grant access for the Background Study on behalf of all the occupants in the Residence.

Signature

Name and Title (PRINT)

Telephone Number(s)

NYC-WTC_000138710