r'd.-T'
' . ‘«y«C»Wff.>m4t«cnt%M&«W»M7SBMi5.*TOWSSrC«AU A/")CfOiOj5 I __________
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT information' /’
2. Project Name: 3. Pmisci *• 4. Project Manager;
2&.W
9. Oats: 6. Bllil
2a. Project Address?
sliding ‘r^ame: ’ ~ i -8. - '
TumarCund Tirne 7
A g
'
da. inweaiigatoi'
9. Comments (FielaJ
CSTAT □ 24 HRS C 72 HRS /Z?rxy6R
UfiMRS O 48 HRS □ NORMAL
BULK SAMPLE LOCATION
10. 11. 12 13. 14. 15. 18.
KofpoflenodS Su(k Sample Maienai Thorroat Sempie Location Material Asijeaoi
Area to No. System TctaTOW. Conienr
No. Floor Sample Coortinaifls (LF.Sr.PfeS)
rnj
2. It
1 n
i
CHAIN OF CUSTODY
IT ReiinquiShad By'
•S. Oars 119 , 20. Recsarsd 6y
Date 22. Tima
23. Method
al SuUmutai
1
REU?
1 -- U/I£Z£2lI WALX-N
US Mail
(I FED./'"
‘WHiiia’'
ui
LAB INFORMATION
24. Nams and Signature 25. Date 26. ume ' 27. Comments (Labi
24a. Analyzed By; 1
241) Analyzed 3y. T T ' 5x4?*^ I
24c"'QC0y:
i i •
it /• f THTOI P 4 "R
P4/«.
NYC-WTC_0001 55964
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000155964Source: NYC Law Department, mirrored locally