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Lead wipe sample chain of custody form, March 2003

Machine-extracted title · confidence 95%

Chain of custody form documenting the collection and transfer of lead wipe samples from 100 Church Street to a laboratory.

NYC-WTC_000174620
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Scanned page image, NYC-WTC_000174620
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

rnc? 3lie.nl LEAD WIPE SAMPLE DAI Pfojecl Name & Address: ' and chain of custody f TRC Field Repiesenlative; Page; Sitfi

New York City Law Department 100 Church st. Zibby Doiinski 1 of 1 Dale: Requested Turnaround Time: IRC ProjEcI Manager. TRC ProjecI No: ' 03/15/03 12 Hrs . NITIN DAVE /OFFICE PHONE: (212) 221-7622 35052-0000-00017 CELL PHONE: (917) 549-3382

WIPE SAMPLE INFORMATION Sample Localion •Area Sampled Tolal Area Sample Humbec Surface Deseripb'on. Inches (Sqin) Floor Rourr/Area Dgscriplion

f/y js v/zi-zi &fr' 20'” Floor ZDO31503LW20O1 12.x 12 144 \,<zc=>T~-Tz.£J/=^ 'Z ° i J xl/r

ZD031E03LW2002 12X 12 144 20“’ Floor xv/lXZ ff F 2 - 3 If _______ ZD031503LW2003 12 X 12 144 20'” Floor _________ CJ ZD031503LW200'1 Field Blank 1 tH-

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SPECIAL INSTRUCTIONS TO LABORATORY J Fax Results To (Name) NITIN DAVE at (Number) Z12-2Z1-7840 o H CHAIN OF CUSTODY DOCUMENTATION AND LABORATORY INFORMATION l"^ Relinquished By Dale Time Received By Date Time Melhod ol Snbmiltal Comtnenls (Lab) ho Field EMSL I. Zihby Do1insi:i 03/15/03 EPA METHOD 305017420 I II. Walk In US Mail n 0 Analysis lot Lead only Name and Signajurfe;^ Pale Dale [lime o _ / I o Fed-^“ n Analyzed — 2'' mI in. Olber n Analyzed Cn QC By; CR OOi

co ! C7l zAO ‘CLzsXl I -1

NYC-WTC_000174620

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NYC-WTC_000174620Source: NYC Law Department, mirrored locally

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