Chain of custody form for air monitoring data

NYC 9/11 Public Portal Document

Page of AIR MONITORING DATA TURNAROUND TIME AND □ 2 hrs □ 6 hrs □ 48 hrs □ Standard ASSOCIATES CHAIN OF CUSTODY FORM □ 4 hrs □ 24 hrs □ 72 hrs □ Other PROJECT INFORMATION 1. Client: ? 7% 6-oom 2 4. Project Monitor: 4c. Rotameter Number;

2a. Project Address , /— 3a. Task # 8. E^EM (0.45 micron MCE) 7 ! 6. Abatement Location;. __ / 7. □ PCM (0.8 micron MCE) 9. Type: c. (g<^batement f. □ Environmental r--'/x-rnv /^/ Cassette Filter Manulacliire/V/ 7 ’ a. □ Background Cassette/Fitter Manufacture _ d. □ Post-Abate g. □ Ambient ^-/5-02 To Lof# _______________ Lol # b. □ Pre-Abate e. □ OSHA h. □ Other

DAILY AIR SAMPLE RECORD 10. 11. 12. Sample Location 13. Time (24 hrs clock) 14. Flow Rate (L/min.) 15. 16. 17. Sample I D. Pump 12a. 12b. 12c. Sample Coordinates 13a. Start 13b. End 13c. Total 14a. Start 14b. End 14b. Total Air Vol. # Fibers/Fields Fiber Cone. F/CC Number Number IWA OWA Avg (liters) Minus Blank

Field Blank

Field Blank

3^ I 2Y<) ■29 7l /V 3 0 At 4^ 3^ c< ^3 7 /• JXi

:z c c Z5/Q a _c. I* #- fYfyliHyl /o CHAIN OF CUSTODY LAB INFORMATION (ATC EUkP # 10879, ATC NVLAP #1187) 18^.Retinittrtshed By; 19. Received By: 20. Date: 21. Time: 22. Lab Name: 23. Date: 24. Time: 25. Microscope Make/Serial #: □ Nikon Labophot 238913 L_ ^7 a. Analyzed By: □ Nikon Labophot 238917 II b. QC By: c. Lab Batch #: n Nikon Labophot 239079 III Analysis Methodology 26. ATC Project Manager; 28. Comments: 27. Result To: PCM - NIOSH 7400A

Beeper/Phone #'s ___ TEM - AHEFiA

WHITE - File YELLOW - Client/Report PINK - Lab GOLDENROD - Field NY-1 d.'OI)

NYC-WTC_000174159