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: ,
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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
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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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