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Chain of custody form, ATC Associates Inc.

Machine-extracted title · confidence 85%

Chain of custody form section detailing project information and turnaround time options for sample tracking.

NYC-WTC_000174922
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Scanned page image, NYC-WTC_000174922
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NYC 9/11 Public Portal Document

C. 3R r^HrilNP mTA. - t p j = TURNAROUND TIME AND ' □ 2 hrs □ 6 hrs □ 48 hri jl] Staiiua0 , .1 ASSOCIATES 1NC. CHAIN OF CUSTODY FORM □ 4 hrs 0 24 hrs 0 72 hrs 7 other7_ PROJECT INFORMATION 1. Client: 2. Project Name 3. J 4. Project Monitor/' ' r 7 4c. Rotametei^ Number: , / n. / ../J /y .7^"' ' ■ 2a. Project Address//'^- z 0 7'1? f' ..-g 3a. Task # 0/7 4a. Air Sampler:

5.,Date: 6. Abatement'Lpdatiqrii , 7. Q PCM (0,8 micron MCE) 8. '0 TEM (0,45 micron MCE) 9. Type: c. □ Abatement f. □ Environmental f a. □ Background d. □ Post-Abate g. □ Ambient Cassette/Fitter Manufacture _ Lot# b. □ Pre-Abate e. □ OSHA h.0 Other

DAILY AIR SAMPLE RECORD 10. 11. 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 Field Blank

Field Blank T

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z' 7 7; ■_y- '4 Ki) / (/ f? ‘ ./k'-C J c ''T r Z y - ‘ 777)///-) 7<W 6 I Z (./ Z Xferf; OdL-r —— •X'z z. h y > ’ "Z n •jZ 3'5 Z/- /z "fG /y • - .' 0', t 7 -j' z'i / XY \ / V ~ r i, 7' & Sz' ' '-I ' /Zio i /

i I CHAIN OF CUSTODY LAB INFORMATION (ATC ELAP # 10879, ATC NVLAP #1187) 18. Reinguishfid By; -: 19. Received By: 20. Date: 21. Time: 22. Lab Name: 23. Date: 24. Time: 25. Microscope Make/Serial #: . L a. Analyzed By: Lf TZTTz V <? I z? □ Nikon Labophot 238913

II z717 ,'F b. QC By: □ Nikon Labophot 238917 □ Nikon Labophot 239079 III c. Lab Batch #: Analysis Methodology 26/ATC Project Managei/ 1 / z 27. ResultTo: t 7W/z/w7/ 28. Comments: PCM - NIOSH 7400A

Beeper/Phone #'s TEM - AHERA

WHITE - File YELLOW - Client/Report PINK - Lab GOLDENROD - Field NY-1 (1/01)

NYC-WTC_OOO1 74922

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NYC-WTC_000174922Source: NYC Law Department, mirrored locally

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