Chain of custody form, ATC Associates Inc.

NYC 9/11 Public Portal Document

core PROJECT INFORMATION ASSOCIATES INC. L

■/ / ■ CHAIN OF CUSTODY FORM V - L .. .. 0^2 hrs L. □ 4 hrs hrs r ___ is hrsf □ 24 hrs □ 72 hrs 1 Stari-" * H Other/£ yI

1, Client: 2. Project Name 4. Project Monitor:J 4c. Rotarneler Number:

2a. Project Address // 3a. Task # /?.o 4a. Air Sampler: r? M’' .. > / _ 5. Date: 6. Abatemd^ Location: EZI-PCM (O.S micron MCE) 8. [2 TEM (0.45 micron MCE) 9. Type: c. □ Abatement f. □ Environmental a. □ Background d. □ Post-Abate g. □ Arnbient if ■-S" Z /ffffif / Cassette/Filter Manufacture __ CasseHe/FilterManufacti^e fJ 7' 5 b. □ Pre-Abate e. □ OSHA h. gj Other Lot# ____________ __ Lot# L

DAILY AIR SAMPLE RECORD 10. T1. 12. Sample Location 13. Time (24 hrs clock) 14. Flow Rate (L/min.) 15. 16. 17. Sample I.D. Pump 12a. 12b. 12c. Sample Coordinates 13a. Start 13b. End 13c. Total 14a. Start 14b. End 14b. Total Air Vol. # Fibers/Fields Fiber Cone. F/CC Number Number IWA OWA Avg (liters) Minus Blank

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CHAIN OF CUSTODY LAB INFORMATION (ATC ELAP # 10879, ATC NVLAP #1187) 18. Relinquished By: 19. Received By: 20. Date: 21. Time: 22. Lab Name: .. 23. bate: 24. Time: 25. Microscope Make/Serial #:

lZZjZZZZZXZZ □ Nikon Labophot 238913 a. Analyzed By: n b.QCBy: □ Nikon Labophot 238917 □ Nikon Labophot 239079 in c. Lab Batch #: Analysis Methodology 26. ATC Project Manager: I Z 77'27. Result To: 28, Comments: PCM - NIOSH 7400A OzT n/f?frf i ' a '■ ;'* Z-’ j' ‘/ Beeper/Phone #'s TEM - AHERA

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