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
1 Client NYC BOE T Project Nam PS 131 M 3 Project# 14584 0875 4 Project Manager Yiannis Efstathiou
2a Project Address 100 Hester Street New York NY 4a In estigator ImmyGhoy ■ >
5 Date 6 B ilding Name PS 131 M 8 Turnaround Time 9 Comments (Field) '
□ STAT □ 0 72 HRS 0 OTHER Analyzed all of them for Fbergl ss
7 Sampling Areas 10 Time in / Time out
06 HRS 048 HOURS 0 NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
HA# NUMBER DESCRIPTION NUMBER
PS 131M 8/22/02
Fiberglass <9/ Settled Dust
P S 131M 8/22/02
Fiberglass 2_ Settled Dust
PS 13IM 8/22/02
Fiberglass Settled Dust
PS 13IM 8/22/02
Fiberglass Settled Dust
PS 13IM 8/22/02
Fiberglass ^5-" Settled Dust 3
P S 131M 8/22/02
3
Fiberglass Settled Dust
P S 131M 8/22/02
Fiberglass Settled Dust AJA
P S 131M 8/22/02
Fiberglass Settled Dust
PS 13IM 8/22/02
Fiberglass Settled Dust
PS 131M 8/22/02 A>7
/
Fiberglass Settled Dust
CHAIN OF CUSTODY Please call Project Manager 646 I'll 1155
17 RI qu shed By 18 Dat 19 Tm 20 Rece ed By 21 D 1 22 Tm 23 Method of
S bm nal
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FIELD
/S'JO WALK IN
\7 US .MAIL
FED X
OTHER
LAB INFORMATION
24 Name d S gnatu e 25 Date 26 Tme 27 Comments (Lab)
24a A alyzed By <
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24b A ly d By
24 QCBy
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CONFIDENTIAL, CITY_21MC100_003431107
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000175452
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