Chain of custody form, air monitoring data, NYC BOE

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PROJECT INFORMATION ^/S__5 CHAIN OF CUSTODY FORM n 2 hrs □ 4 hrs 0 6 hrs □ 48 hrs 0 24 hrs 072 hrs □ Standard^ -ITKIther 7 \ It'S/ i “0 c CT o o' o 1 Client 2 Protect Name y 4 Proiect Monitor 4c Rotameter Number o "0 2a Proiect Address 4a Air sampler o Ol cn 9L o 5 Date 6 Abatement Location , , , . 7 I 1 PCM (0 8 micron Mbf) 8 (0 45 micron MCE) 9 Type c Q Abatement I □ Environmental o Cassettc/Fllter Manufacture 7^/7?/___ O Cassette/Fillei Maiiulacliiie _ a □ Background d □ Posi-Abate 9 ^^rnbien! o o Lol# ______________ Lot# o.2/(9ZJ/Z b □ Pre-Abate e □ OSHA h □ Other c 3 CD DAILY AIR SAMPLE RECORD 3 10 11 12 Sample Location 13 Time (24 hrs clock) 14 Flow Rate (L/min ) 15 16 17 w Sample 1D 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 G Number Number IWA OWA Avg (Iders) Minus Blank co G M O H a/ Field Blank

Field Blank H O /Pz^. /I/3 no 20 ^^0 -2.0 O M O O H H O S / 2.0 £.o < G H H a 3/''s6 o H 3cO g.o 50 a M 2 H Hl Z 50 > 3/3 0^:3 ( //:33 2.0 S O ' f 2.d >33^' ro

w // M no H // - 3^ /S '3'3^/fC} ^-0 2.^ O O CO CHAIN OF CUSTODY LAB INFORMATION (ATC ELAP/ 10879, ATC NVLAP #1187) Q 25 Microscope Make/Senal # 18 Relinquished By 19 Received By 20 Date 21 Time 22 Lab Name 23 Date 24 Time 1"^ H

11 < 7 ' a Analyzed By b QCBy /27Z^ l7Ez-,4-,.... □ Nikon Labophot 238913 □ Nikon Labophot 238917 S □ Nikon Labophot 239079 o III c Lab Batch # o Analysis Methodology o 26 °ro|ect Manager 28 Comments I 27 Result To PCM - NIOSH 7400A o o co Beeper/Phone #‘s TEM - AHERA co WHITE - File YELLOW - Client/Report PINK Lab GOLDENROD - Field NY-1 (1/01)

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