Chain of custody form for air monitoring data

NYC 9/11 Public Portal Document

( of__21 1ky AIR MONITORING DATA Page TURNAROUND TIME ANO □ 2tire Dehra □4ehrs aSUTKiaid » • I n c I t 1 I < lite. CHAIN OF CUSTODY FORM □ 4 hrs ^OtCTirs □7?hrs Q Other p PROJECT INFORMATION o 1. Client: 2ProiectWameq^g.ft _ u/^ 4. Project Monitor 4c. Rotametei Number: o - OOP! 2a. lYeisct Address J Ce^ffaC 4a.AirSamp(«: - 0 06 G. Abitement Location: 7. [g’pCMfe.eiiHB.Akr.E) 1B. Gf Tew (0.45 mlttaR dCQ SLIypa c. □Abatement f. □ Environmental o 5. Date: co CuMiteWMmnrtpi____________ ___ CUKlA'nnA-M)fAi(actin _ a. □ Background d. □ Post-Abate g.nAinblent 10,0^.0^ tw* o(x^.SloA L«f b □ Pre-Abate e. □ OSHA II. □ Other ?X daily AB SAMPLE RECORD__________ Ff ^er N» M KJ 10 11. '12. Simple Location. " 113. nnw (24 bfs dock) 14 Floy/ Rate (tymin.) IS. 16. 17 O Sample l b. Pump lai^suitTiaOnT Ha Start 114b.’End |l4b. Total Air Vol. # fibets/Helils Fiber Cone FAiC ' WA 12b. ^c.'SamplB CoontiiMtes 13c. Total Minus Blink '•-71 o Number Number (Was)

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FR Prt osl vZ f6t31 Sil <0l to to 3e»/Q Fb-pHoj SZ>o (0 to lo Sloo e2€f/ \Z 15 F^or, A^f^w<evJ, SL^’-oi Sil to (0 to V 16'^6 a5to6 Sio to to to •3^00 ^/too <a^/ V as 07 S73 fO «3 to S790 V to (/) tQ S7i.Q v S77 10 to tQ '3770 ^/(Oo V iiv fCcOC SUz /6S1 S7S fO to to ’ilSOJ-Maa /O 3YM0 FfcS3 *• 37 H to lO CHAIN OF CUSTODY__________ LAB INFORMATION (ATC ELAP #10679, ATC NVLAP #1187) to. Be^isli^ By. 19.RecBiw!<IBy: I 2G.03te: I 21. lime: 1 22. tab Kame; __ _____ 23,q»te; 24.rimB: 25. I C>^4<71^ lAnalFWltiy: □ Nikon Labophot 230917 n________ b.QCBy: c Lab Bach# / □ kkkon Laboptiol 239079 ra Analysis Methodology IS 26. ATC Project Manaflw 27 KesuNTo: B. 28. Comrnents: o /PCM -NIOSH 74000^ o K5

B«ep«r/Pbone *'s TEM - AHERA WHITE File YELLOW - ClienVRepoft PINK-Lab GOLDENROD - Raid NY-1 (I AM)

NYC-WTC_000174181