NYC 9/11 Public Portal Document
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ATC ASSOCIATES INC. BATCH NO.
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT INFORMATION
I Client: NYC-BOE 2. Project Nam AHERA REINSPECTION 3. Project # 145S4-0823 4. Project Manager: Yiannis Efstathiou
2a- Project Address:292 Greenwich street. New York, NY 10007 4a. InvestigatortChacko Mathew
5 Date: 6- Buiic ing Name:PS234M S. Turnaround Time: 9. Comments (P'ield):
□ STAT 0 24 HRS 0 72 HRS 0 OTHER Analyzed all of them for fiberglass
3^3 7. Sampling Areas. 10 Time in / Time out:
0 6 HRS 0 48 HOURS 0 NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER DESCRIPTION NUMBER
PS234M-3/23/02-
G-vv^ I
11 Fiberglass- «1 Settled Dust
PS234M-3/23/02-
Fiberglass- '9- Settled Dust
PS234M-3/23/02-
KV \«J S I 4
13 Fiberglass- Settled Dust
PS234M-3/23/02-
IM Fiberglass- (if
PS234M-3/23/02-
Settled Dust IL •X'l.-l
x23
■3.C. S
IS Fiberglass-
PS234M-3/23/02-
Settled Dust AXA
it CvXo^i )
lb Fiberglass-
PS234M-3/23/02-
IU Settled Dust
•iR At (yUoA3
A/A
17 Fiberglass- i "1 Settled Dust
PS234M-3/23/02-
Fiberglass- ( Settled Dust
PS234M-3/23/02-
Fiberglass- 1*1 Settled Dust
PS234M-3/23/02-
V \O4>
V"t>r
Fiberglass- 9-'^ Settled Dust
CHAIN OF CUSTODY
17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of
Submittal:
FIELD
T'/l WALK IN
7 US MAIL
FED-X
OTHER
LAB INFORMATION
24. Name and Signature; :25. Date: 26. Time; 27. Comments (Lab):
24a. Analyzed Bv:
24b. Analyzed By:
24c. QC By:
Filename- P:’USERS\DATA\WF96^WP\FO{<MS\NY-13 XLS FonnNY-l?
CONFIDENTIAL, CITY_21MC100_011530649
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000175982
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