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Chain of custody form, fiberglass bulk sample, PS 1

Machine-extracted title · confidence 95%

Documentation tracking the collection and transfer of a fiberglass bulk sample from a New York City Department of Education site for laboratory analysis.

NYC-WTC_000175497–000175498
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NYC 9/11 Public Portal Document

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ATC ASSOCIATES INC. BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION 1 Client NYC - BOE 2 Project Nam PS IM 3 Project# 14584-0869 4 Project Manager Yiannis Efstathiou

2a Project Address 8 Henry Street, New York.NY 10038 4a Investigator //■ ^^4)^ Dale 6 Building Name P S 1 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 048 HOURS □ NORMAL SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A# NUMBER DESCRIPTION NUMBER P.S. lM-8/24/02-

Fiberglass- Settled Dust 5 P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02- 3 J Fiberglass- Settled Dust I P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02- Fiberglass- Settled Dust P.S. lM-8/24/02-

Fiberglass- Settled Dust CHAIN OF CUSTODY Please 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

'USTvIAIL FED-X OTHER

LAB INFORMATION 24 Name and Signature 25 Date 26 Time 27 Comments (Lab) 24a Analyzed By A'/ ///-TzY^ 24b Analyzed By 24c QCBy

Filmamc P 'USERStDATA\WP96\WP\PORMS\NY-l3 XLS ForniNY-B

CONFIDENTIAL, CITY_21MC100_003431283 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000175498

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NYC-WTC_000175498Source: NYC Law Department, mirrored locally

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