NYC 9/11 Public Portal Document
P.07/13
MAY-10-2002 16:24
ATC ASSOCIATES INC.
environmental geotechnical and materials professionals
Chain of Custody
I Client Name Address
PH
Location ATC Client# ATCJob#
125 CEDAR STREET, Pll i CASH
Samples Numbers Number of Samples
01 - 03 Is
Samples Collected By Date Collected
Client 11/19/01
Type of Sample (circle one)
Air Sample Sulk Sample Water Sample Other
Type of Analyses Requested (circle one)
TEM PCM AA-Flame AA-Furnace Other
Turnaround Time (Please ensure laboratory can accommodate the request before sending: circle one)
2 hr, 4 hr. 6 hr. 12 hr. 24 hr. 48 hr. 72 hr. 3-5 days 5-10 dayg Other
Transmittal of Results
□ Standard Report Turnaround (5-7 working days)
n Plegss Telephone results to
Telephone # by on
(Time) (Date)
□ Please Fax results to
Fax#_________ _ by on
(Time) (Date)
□ Additional instructions
Batch # 3309
Sample Integrity (To be filled out by laboratory only) Number of Samples 3. Condition of Samples ® Accept □ Raject
. Lab Comments
Relinquished By Received By Time Date Reason for Change of Custody
Client iwL " 11/19/01
Additional Comments
NYC-WTC_000155928
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000155928Source: NYC Law Department, mirrored locally