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Chain of custody form for air monitoring data

Machine-extracted title · confidence 85%

Blank chain of custody form used to document the collection and transport of air monitoring samples for environmental testing.

NYC-WTC_000174162–000174164
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Scanned page image, NYC-WTC_000174164
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OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Page of AIR MONITORING DATA TURNAROUND TIME AND □ 2 hrs Lj G hrs j 40 lirs | j Standard ASSOCIATES INC CHAIN OF CUSTODY FORM L ) 4 hrs I I 24 hrs | j' Z2 hrs | | Other __ PROJECT INFORMATION 1. Client: 2. Project Name 3. Project# <. 4. Project Monitor 4c. Rotameter Number: U/-A ■—■ I A*- 2a P,01M ™.KS Cc>i>r'Si 3a. Task # 4a. Air Sampler: L F Zf f, cooo'y. 5. Date: 6. Abatement Location, 7. PCM (0.8 micron MCE) 8. IpfEM to.45 miernn MCE) 9. Type: c. [' ] Abatement I I I Environmental _ a. □ Background d. [ J Post Abate g I I Ainhient 9 I S' Casselte/Fiiler Manufacture ___ Cassette/Titter Manufacture Lot#^16 h. NJ-Othei {'(ittt l.ol # b. □ Pre-Abate e. □ OSHA

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 12b. 12c. Sample Coordinates 13a. Start 13t). End 13c. Total 14a. Start 14b. End 14b. Total Air Vol # Fibers,FieltLs Filler Cone. F/CC 12a. Number Number IWA OWA Avg (liters) Minus Blank

Field Blank

Field Blank

IT V Rt s U- C fe&u. rco.i< ZY-35 7 IO ( fO ZV

CHAIN OF CUSTODY LAB INFORMATION {ATC ELAP # 10879, ATC NVLAP #1187) 18. Relinquished By: 19. Received By: 20. Date: 21. Time: 22. Lab Name: /f /C -- 23. Date: 24. Time: 25. Microscope Makc/Serial #; ( I Nikon Labophot 238913 I C>'^3 Y / C 9.isi a. Analyzed By: fe' oo I I Nikon Labophot 238917 11 Ya b. QC By: I I Nikon Labophot 239079 in c. Lab Batch #: Analysis Methodology 26. ATC Project Manager: 28. Comments: 27. Result To: PCM - NIOSH 7400A F. ac Beeper/Phone #'s TEM ■ AHERA

WHITE - File YELLOW - Client/Repori PINK - Lab GOLDENROD - Field NY-I (1..'01)

NYC-WTC_000174164

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NYC-WTC_000174164Source: NYC Law Department, mirrored locally

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