Bulk sample data and chain of custody, PS 234M

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ATC ASSOCIATES INC. BATCH NO. y. _____________ BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION 1. Client: NYC-BOE 2. Project Nam AHERA REINSPECTION 3. Project# 14584-0823 4. Project Manager: Yiannis Efsiathiou

2a- Project Address:292 Greenwich street, New York, NY 10007 4a. InvesngaiorChacko Mathew

5- Date; t). Building Name;PSx34M 8. TumaroLind Time; 97Comrnents(Fjeicr)i □ STAT □ 24 HRS □ 72 HRS 0 OTHER Analyzed all of them for fiberglass 7. Sampling Areas; 10. Time in / Time out; □ 6 HRS 048 HOURS O NORMAL

SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER

PS234M-3/23/02- - *Y». >0 F1« 0 4 Fiberglass- CI Settled Dust 1 PS234M-3/23/02- Sto c. n (aa Vavi'n4 - CuV Fiberglass- e 9- Settled Dust Xoe\VV> CyS'-'T'V ConcXiVe Floot^

PS234M-3/23/02- 3 Fiberglass- C 3 PS234M-3/23/02- Settled Dust O\A,V 1 /W Fiberglass- & M- Settled Dust Cft. V A. LY 1 \ .,ccr 3 TS234M-3/23/02- OAs A e- t C. s Fiberglass- OS PS234M-3/23/02- Settled Dust C \ /Y Nc* •( YS A Fiberglass- o U Settled Dust C Co«AX<-V<. SL-iV \ A£i PS234M-3/23/02- -*5"- 1 Fiberglass- q"} Settled Dust Cs, L-< e Vet- A .<<-«- A I PS234M-3/23/02- Fiberglass- C’*? Settled Dust So aVc- e<-- 3 1 PS234M-3/23/02- 1 Fiberglass- 0*1 PS234M-3/23/02- Settled Dust Mi Cv^ o ’A Ct-iV ) 10 Fiberglass- Settled Dust C Vr.--. X /U) CHAIN OF CUSTODY 17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Subminai:

r FIELD WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Dale; 26. Time; 27. Comments fLab):

24a. Analyzed By:

24b. Analyzed By: 24c. QC By;

Filename. P:\USEFlS\DATA\WP9b\WP\FORMS\NY-l3.XLS Fonn NY-13

CONFIDENTIAL, CITY_21MC100_011530648 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000175981