Chain of custody form for air monitoring data

NYC 9/11 Public Portal Document

Page AIR MONITORING DATA TURNAROUND TIME AND □ 2 hrs □ 6 hrs U 48 hrs I I Standard ASSOCIATES INC CHAIN OF CUSTODY FORM □ 4 hrs 0 24 hrs □ 72 hrs □ Other PROJECT information 2. Project Name 4. Project Monitor: 4c. Rotameter Number: 1. Client: <2^ P 3a. Task # _

5. Date: 6. Abatement Location: 2a. Project Address Itr 7. [^ZiPCM (0 8 micron MCE) fr8. J^TEM (0.45 micron MCE) OQscs 4a. Air Sampler:

9. Type: t t'------- c^?^batement cy / f. □ Environmental Cassette/Filter Manufacture ., Cassetle/Filter Manufacture a. □ Background d. □ Post-Abate g. □ Ambient L.ot #____ ___________ Lot# b- □ Pre-Abate e. □ OSHA h. □ Other

3AILY AIR SAMPLE RECORD 10. 11. 12. Sample Location 13. Time (24 hrs clock) 14. Flow Rate (tymin.) 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

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:hain of custody LAB INFORMATION (ATC ELAP # 10879, ATC NVLAP #1187) 18. Relinquishe^FBy^ 19. Received By: 20. Date: 21. Time: 22. Lab Name: 23. Date: 24. Time: 25. Microscope Make/Serial #:

a. Analyzed By: □ Nikon Labophot 238913 I b. DC By: □ Nikon Labophol 238917 It c. Lab Batch #: □ Nikon Labophot 239079 111 Analysis Methodology '6- ATCProject Manager: 28. Comments: PCM - NIOSH 7400A irx I ^'>^eeper/Phone#'s __ TEM - AHERA

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

NYC-WTC_000174161