Chain of custody form, air monitoring data, NYC BOE

z z Page <5 -< AIR MONITORING DATA o o AND TURNAROUND TIME CD

§o CHAIN OF CUSTODY FORM □ 2 hrs □ 4 hrs 0 6 hrs □ 48 hrs 0 24 hrs □ 72 hrs □ Standard „ 5^Other /Ta/^/f / “0 c I PROJECT INFORMATION o o' o 1 Client 2 Project Name 4 Project Monitor 4c Rotameter Number o "0 Ol 2^2OIL 2a Project Address^ 3a Task# _________________ o O1 8 jXdTEM (0 45 micron MCE) 5L o 5 Date 6 Abatement Location 7 I I PCM fOfl mtcrorfcE) 9 Type c □Abatement t □ Environmental O Cassetle/Ffller Manufacture _ Cassette/filter Manufacture a □ Background d □ Post-Abate g 522Ambient o o c Lot# Lot# b □ Pre-Abate e □ OSHA h □ Other 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 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 G Number Number (liters} ro IWA OWA Avg Minus Blank G H Field Blank o H Field Blank H O <€/» 03 /S -'^0 2^0 A 0/2)56 ?3 O /3 H M O O H H O S 2.^ £.O < G M H a O H pa s jg, £> O M H H /350 G >

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to /^ o o co CHAIN OF CUSTODY LAB INFORMATION (ATC ELAP #10879, ATC NVLAP #1187) Q 18 Relinquished By 19 Received By 1 / 20 Date 21 Time 22 Lab Name 24 Time 25 Microscope Make/Serial # H K a Analyzed By □ Nikon Labophot 238913 I 25# II / b QCBy □ Nikon Labophot 238917 S 111 c Lab Batch # □ Nikon Labophot 239079 o o Analysis Methodology o 26 ATC Project Manager 28 Comments I 27 Result To I PCM - NIOSH 7400A o o co Beeper/Phone #'s TEM - AHERA JIG co WHITE - File YELLOW - Chent/Report PINK - Lab GOLDENROD - Field NY 1 (1/01)

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