Chain of custody form for air monitoring data, NYC BOE

Z AIR MONITORING DATA Page 4 Z O TURNAROUND TIME o g AND co □ 2 hrs □ 6 hrs □ 48 hrs □ Standard o ASSOCIATES g CHAIN OF CUSTODY FORM □ 4 hrs □ 24 hrs 0 72 hrs Other GSu-sIt I PROJECT INFORMATION “0 o c o 1. Client: 2. Project Name 3. Project # 4. Project Monitor: 4c. Rotameter Number: CT o iS/M A//A o' cn P O. £ 2a. Project Address IGO Gf. 3a. Task # 4a. Air Sampler: TC ____ H Poos "0 o 5. Date: 6. Abatement Location; 7. Q PCM (0 8 micron MCE) 8- ^TEM (0 45 micron MCE) 9. Type: o c. ^Abatement f. □ Environmental 9L h-'j a Ou >)< MMt a. □ Background O Cassette/fifter Manulaciuie _ Cassette/Filler Manufacture . d. □ Post-Abate g.^^mbisnt o Schoo I . Lot# Lot# . b. □ Pre-Abate e. □ OSHA h. □ Other o c DAILY AIR SAMPLE RECORD 3 CD 10. 11. 12. Sample Location 13. Time (24 hrs clock) 14. Flow Rate (L/min.) 3 15. 16. 17. w Sample I.D. Pump Total Air Vol. # Fibers/Fields Fiber Cone. F/CC G 12a. 12b. 12c. Sample Coordinates 13a, Start 13b. End 13c. Total 14a. Start 14b. End 14b. 03 Number Number IWA OWA Avg (liters) Minus Blank G M Field Blank O H Field Blank H o 23 hl QOS ICO9 23 O 19 8 8 d H M O O H O S nt] ^0 14 IO L 8 8 8 tq3G M a O M 23 s a H M 23 S O

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to o o co CHAIN OF CUSTODY LAB INFORMATION (ATC ELAP # 10879, ATC NVLAP # 1187) O 18. Relinquished By: 19. Received By: 20. Date: 21. Time: 22. Lab Name: —yjgxy 23. Date: 24. Time: 25. Microscope Make/Serial #: H K I /£7J^ □ Nikon Labophot 238913 I 7 .^^a. Analyzed By: ho □ Nikon Labophot 238917 II b.QCBy: s O III c. Lab Batch #: □ Nikon Labophot 239079 o ■

Analysis Methodology o 26. ATC Project Manager: 28. Comments: I 27. Result To: o PCM ■ NIOSH 74O0A o co Beeper/Phone #'s: -//< C TEM - AHERA CO WHITE-File YELLOW - Client/Report PINK - Lab GOLDENROD - Field NY-1 (1/01)