NYC 9/11 Public Portal Document
Page 3) of U+-
ATC ASSOCIATES INC. BATCH NO.
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT INFORMATION
1. Client: NYC - BOE 2. Project Nam AHERA REINSPECTION 3 Project# 145S4-0S23 4. Project ManagertYiannis Efstaihiou
2a. Project Address;29- Greenwich street, New York, NY 10007 4a. lnvestigator:Chacko Mathew
5 Dale: 0. Building Nanie;PS234M 8 Ttimaround Time: 9. Comments (Field):
□ STAT Q 24 HRS □ 72 HRS □ OTHER Analyzed ail of them for fiberglass
7. Sampling Areas: 10. Time in/Time out:
O 6 HRS □ 48 HOURS Q NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.S NUMBER DESCRIPTION NUMBER
PS234M-3/23/02-
<3-1 Fiberglass- 2-1 Settled Dust
PS234M-3/23/02-
CC-SS A-oorO
9-1-
Fiberglass- "J. 1- Settled Dust
PS234M-3/23/02-
C.\ c, Si V) ire ON -5_-X—I C J)
'iA- Fiberglass-
PS234M-3/23/02-
Settled Dust Aid
C \ 038 J)
un Fiberglass- 2-'-r settled Dust
PS234M-3/23/02-
Fiberglass- 2.^ Settled Dust
PS234M-3/23/02-
Fiberglass- O-C Settled Dust
PS234M-3/23/02-
C-Ve-Si 4 op
Fiberglass- 0.-T Settled Dust
PS234M-3/23/02- C.\c,^ i Tf oo irfN
Fiberglass- S-'k Settled Dust /cD
PS234M-3/23/02-
(V
*.*1 Fiberglass- 2-^
PS234M-3/23/02-
Settled Dust XL)
rr> T.\S
3® cA<^is
Fiberglass- Settled Dust
CHAIN OF CUSTODY
17. Relinquished By; 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time; 23. Method of
Submittal:
FIELD
JeV"- W.ALK IN
US MAIL
FED-X
OTHER
LAB INFORMATION
24. Name and Signature; 25. Date: 26. Time: 27. Comments (Lab);
24a. Analyzed By:
24b Analyzed By:
24c. QC By:
Filename: P:\USERS\DATA\WP96\Wp\FOIUvlS\NY-l2.XLS Form NY-13
CONFIDENTIAL, CITY_21MC100_0 11530650
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000175983
OCR can misread numbers and units. Confirm readings against the page image before using them.