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Bulk sample chain of custody form, PS 89M, Jan 2002

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Chain of custody form for bulk asbestos samples collected at PS 89M as part of an AHERA reinspection in January 2002.

NYC-WTC_000174722
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NYC 9/11 Public Portal Document

Page / of / ASSOCIATES INC. BATCH NO. ____________ BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT UN FORMATION 1. Client: NYC - BOE 2. Project Nam AHERA REINSPECTION 3. Project# 19125-0246 4. Project Manager: ANDREAS ANDREOU

2a. Project Address:201 Warren Street, New York, NY 10282 4a. Investigator:Yiannis Efttathiou

5. Date: 6. Building Name:PS 89M 8. Turnaround Time: 9. Comments (Field); □ STAT □ 24 HRS □ 72 HRS Q OTHER Analyzed all them far fiberglass 7.. Sampling Areas: Entire 10. Time in/ Time out: O 6 ITRS O 48 HOURS Q NORMAL SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER PS89M -1/11/02- *430/ C •s Fiberglass Y5 J Settled Dust vjgfe-tUta:: PS89M-1/11/02-

Fiberglass Settled Dust PS89M-1/11/02- Fiberglass Settled Dust J eoTf J/ck: PS89M-1/11/02- Fiberglass Settled Dust PS89M-1/11/02- 6/c^foorrj Fiberglass - Settled Dust PS89M -1/11/02- Fiberglass (Miu Settled Dust PS89M-1/11/02- Fiberglass - Settled Dust PS89M - 1/11/02- Fiberglass - QP Settled Dust PS89M - 1/11/02- Fiberglass Settled Dust ft PS89M-1/11/02- Fiberglass - jQ Settled Dust V CHAIN OF CUSTODY 17. Reliiiqcislied By: I 8. Date: 19. Time: 20. Received Dy: 2! Date; 22. Time: 23. Method of Submittal: FIELD A# WALK IN : / / 7 / US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: 27. Comments (Lab); 24a, Analyzed By:

.24'0. Analyzed By. i24c. QC By:

filename; P:\USERS\DATA\WP36\WP\FOR.MS\NY-t3.XLS Form NY-13 -

CONFIDENTIAL, SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008 CITY_21MC100_014660018

NYC-WTC_000174722

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NYC-WTC_000174722Source: NYC Law Department, mirrored locally

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Form recording sample identification and custody chain for AHERA reinspection at P.S. 234M.

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