NYC 9/11 Public Portal Document
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ydrc ASSOCIATES INC. BATCH NO. . —>
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT INFORMATION
1. Client: NYC - BOE 2. Project Nam AHERA REINSPECTION 3. Project# 14584-08IS 4. Project Manager: ANDREAS ANDREOU
2a. Project Address:201 Warren Street, New York, NY 10282 4a. Investigator:Yiannis Efstathioii
5. Date: 6. Building Name:P.S. SQM 8. Turnaround Time; 9. Comments (field):
I Q STAT Q 24 HRS Q 72 HRS Q OTHER
7. Sampling Areas:Backbags 10. Tii^in / Tirde out:
□ 6 HRS Das HOURS □ NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER DESCRIPTION NUMBER
PS89M -1/11/02-
Tape- Settled Dust HP
PS 89M -11/2- ^577747^^4?/^ 4
JLtside hc-cKb^
Settled Dust
PS89M -1/11/02'-
Settled Dust /Vp
PS 89M -1/11/02-
Tape - J- Settled Dust
PS 89M - 1/11/02 -
Tape - Settled Dust S-<^O ND
CHAIN OF CUSTODY
17. Relinquished By; 18. Date: 19. Time; 20.. Received By: 21. Date: 22. Time; 23. Method of
Submittal:
FIELD
WALK IN
US MAIL
FED-X
OTHER
LAB INFORMATION
24. Name and Signature;// 25. Date; 26. Time: 27. Comments (Lab);
24a Analyzed Ry:
24b. Analyzed By:
24c. QC By; /
Filename; P;\USEKS\DATA\WP96\WP\FORMS\NY-13.XLS Form NY-13
CONFIDENTIAL, SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008 CITY_21 MC100_014659867
NYC-WTC_000174693
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