Chain of custody form for air monitoring data, NYC BOE

NYC 9/11 Public Portal Document

AIR MONITORING DATA Page 1 of TURNAROUND TIME AND □ 2 hrs □ 6 hrs □ 48 hrs □ Standard ASSOC CHAIN OF CUSTODY FORM □ 4 hrs □ 24 hrs □ 72 hrs Mother *-> PROJECT INFORMATION 1 Client 2 Project Name 3 Project# 4 Project Monrtor 4c Rotameter Number Lil M A/ /a Hof 2a Project Address l<oo 3a Task# 4a Air Sampler Ju Ct oy HPcc 5 5 Date 6 Abatement Location 7 n PCM (OSmconMCE) 8 ^^TEM (0 45 me MCE) 9 Type c □ Abatement f □ Environmental -< G-< U o 1 C tte/RH Man t b _ c Its^Fll M ut t rviM-x a □ Background d □ Post Abate fl ^fe^Ambienl T F ) 7 + d Fl I I# ________________ lot# b □ Pre Abate e □ OSHA h □Other

DAILY AIR SAMPLE RECORD 10 11 12 Sample Location 13 Time (24 hrs clock) 14 Flow Rate (L/min) 15 16 17 Sample ID 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 w Number Number G IWA OWA Avg (liters) Minus Blank co Field Blank M O H 2i> ZsZikd # 4^ » •) VW I

H O 2 2 I O He f 8 9 O H M Hall O H o o 2 3 I leg 8 B H’iS < 2 M a Hq 11 by O 2 M 3 <37(0 me 8 5 a (W a H M 2 > HuU 2121 Of, M 11 iS S o 7 XMI 8 8 3 \2lajin FriV-^Qkt f. Oia It «& 1H| 8 3 3 w M 2 H kl' I"!- Nlqu L. bloy/ c7iq iiat 8 £ 3 1936 O O CHAIN OF CUSTODY LAB INFORMATION (ATC ELAP # 10879 ATC NVLAP #1187) CO 18 Relinquished By 19 Received By 2(j Date 21 Time 122 Lab Name 23 D^te 25 Microscope Make/Serial # O 24 Time

l"^ H rszszzz Il T7I /|l^a Analyzed By b DC By □ Nikon Labophot 238913 □ Nikon Labophot 238917

S III c Lab Batch # □ Nikon Labophot 239079 o 28 Comments Analysis Methodology o 26 ATC Project Manager I o 27 Result To Y hVHaH .igU_______ PCM NIOSH 7400A o o V" tFi'Ik'Fk o Beeper/Phone # s f 7X h TEIVl AHERA co CO WHITE File YELLOW Client/Repod PINK Lab GOLDENROD Field NY 1 (1/01)

cn CO

NYC-WTC_000175470