Chain of Custody Form Instructions for WTC Building Sampling

NYC 9/11 Public Portal Document

SECTION 3. Information for SAMPLE taken OUTSIDE of the building A. Location number of Sampling Event B. Side of building where sample was taken? (see reference site sketch)

Sidel Side! Sides Side 4 Other Side (_______

C. Is sample location (with sample number) shown on map? Y N

D. How far is the sample location from the building edge? (feet)

E. How far is the sample location from the nearest busy street? (feet)

F. Is there obvious evidence of WTC generated dust visible? On building Y N On adjoining sidewalk Y N On street near the building Y N On roof Y N Not Available Applicable Have these areas been cleaned since WTC collapse? Y N G. Are there dust generating activities in the area? Construction Y N Road work Y N Truck traffic Y N Heavy car traffic Y N Bus stop Y N

H. Is dust visible? In this area where dust sample will be gathered Y N On the surface where the air sampler will be set-up Y N In the air of this area Y N

I. For dust samples, estimate the size of the area sampled (specify units) If this information is included in the chain of custody form please skip this question.

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