Asbestos air monitoring chain of custody form, Jan 2002

NYC 9/11 Public Portal Document

ASBESTOS PROJECT AIR MONITORING DATA AND CHAIN OF CUSTODY FORM Client . Project Manager Laboratpry/Location Turnaround Time

I □ Immediate □ 3 Hours □ 6 Hours .12 Hours Project Name & Location Project Monilor/Air Sampling Technician

/oo ' CyQAM'/d □ 24 Hours □ other Potometer Type ■ -^K^CM (0.8) micron MCE □TEM (0.45) micron MCE Project Number Date , Number □ Background □ Post-Abatement □ Environmental 3 ^^5 2- OOD Ci- Cassette Filler Cassette Filter □ Pre-Abatement □ OSHA ^^a^bient Manufacturer: Manufacturer; oooo 4 >7 Lot_____________ . _ Lot■ □ Abatement □ other AIR SAMPLE INFORMATION I Sample Data Time (24 Hr. Clock) Flow Rate (L/Min.) # Fibers/ Sample Total Air Fields Fiber/ I.D. Pump Total Volume Minus Structure Number Number IWA OWA I Sample Location Start End (Minutes) Start End Ayg, (liters) Blank Cone.

C,^7 ■5oo C7/O 5 5 G$g' Z./T Joo 5 5 pc00^ 42^0 ”360 5 5 5 5 5 Fuuu-C -/ /2/< 5 5 /jwo C4-r-t| (d^/2. CM-' pecTuTC—————— od/7 42/7 34^ 5 5 z^oo G5/3 -y So’'^ -€4-^ rA z^/5 5 5 5 osl (Froc>/'C So pT’ h laUL-S /-^z? /4i77 560 5 $ 5 CHAIN OF CUSTODY cb i/r / zu Relinquished By: Date , Time Dale Time Lab ELAP No. Date Time Microscope Analyzed B'2T)njy2' Make/Serial No.

QC By Lab Batch No.

Transmit Results To Fax No. Pager No. Comments; Analysis Methodology PCM - NIOSH 7400A TEM-AHERA 013654' TEM-NIOSH 7402

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