NYC 9/11 Public Portal Document
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ATC ASSOCIATES INC. BATCH NO. „
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT INFORMATION
I. Client: NYC - BOE 2. Project Nam PS 131 M 3. Project# 14584-0875 4. Project Manager: Yiannis Efsiathiou
2a. Project Address: 100 Hester Street, New York,NY 4a. Investigator: Jimmy ghoy ■ .
Date; 6. Building Name: P.S. 131 M 8. Turnaround Time: 9. Comments (Field); '
□ STAT □ □ 72 HRS □ OTHER Analyzed all of them for fiberglass
7. Sampling Areas: 10. Time in / Time out:
□ 6 HRS □48 HOURS □ NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER DESCRIPTION NUMBER
P.S. 131M-8/22/02-
Fiberglass- c>/ Settled Dust
P.S. 131M-8/22/02-
Fiberglass- £)2_ Settled Dust
P.S. 131M-8/22/02-
Fiberglass- Settled Dust
P.S. 131M-8/22/02-
Fiberglass- iQ/a Settled Dust
P.S. 131M-8/22/02-
Settled Dust 3
Fiberglass- 05”
P.S. 131M-8/22/02-
3
Fiberglass- Settled Dust
P.S. 131M-8/22/02-
Fiberglass- Settled Dust
P.S. 131M-8/22/02- - "2
Fiberglass- Settled Dust
P.S. 131M-8/22/02-
Fiberglass-
P.S. 131M-8/22/02-
Settled Dust X2A
/
Fiberglass- Settled Dust
CHAIN OF CUSTODY P ease call Project Manager 646-772-1155
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 By; A/ <>/!./ts7l^ < ih /7 /’Z/X
24b. Analyzed By:
24c. QC By:
Filename; P:\USERS\DATA\WP96\WP\FORMS\NY-13.XLS Form NY-13
CONFIDENTIAL, CITY_21MC100_0 11530625
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000175391
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