Chain of custody form for air monitoring data

NYC 9/11 Public Portal Document

Page of AIR MONITORING DATA TURNAROUND TIME AND n 2 hrs □ 6 hrs n 48 hrs □ Standard ASSOCIATES INC CHAIN OF CUSTODY FORM □ 4 hrs n 24 hrs □ 72 hrs □ Other ROJECT INFORMATION _______________________ Client- 2. Project Name n 4. Project Monitor: 4c. Rotameter Number: 1/ 2a. Project Address ’”*■'00 4V- 4a. Air Sampler; /A,V~ Sr Date: 6, Abatement Location: 7. □ PCM (0 8 micron MCE) TEM (0,45 micron MCE) 9. Type: C'^^batement t. □ Environmental Cassette/Filter Manufacture _ Cassette/Filter Manufacture a. □ Background d. □ Post-Abate g. □ Ambient Lot# _______________ Lot# b. □ Pre-Abate e. □ OSHA h. □ Other

AILY AIR SAMPLE RECORD 0. 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

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(O (o eo HAIN OFC STODY LAB INFORMATION (ATC ELAP # 10879, ATC NVLAP #1187) 19. Received By: 20. Date: 21. Time: 22. Lab Name: 25. Microscope Make/Serial #: 8. Relinquislied

I Hz a. Analyzed By: b. QC By: □ Nikon Labophot 238913 □ Nikon Labophot 238917

c. Lab Batch #; □ Nikon Labophot 239079 II Analysis Methodology '6. ATC Projed Manager: 28. Comments: 27. Result To: PCM - NIOSH 7400A

f Jeeper/Phone #'s TEM - AHERA

WHITE - File YELLOW - Client/Report PINK - Lab GOLDENROD - Field NY-1 (1,01)

NYC-WTC_000174160