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Bulk sample data and chain of custody, P.S. 89M, June

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Chain of custody form listing bulk samples collected at P.S. 89M on June 21, 2002, for analysis of fiberglass fiber content.

NYC-WTC_000177212–000177215
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NYC 9/11 Public Portal Document i'age of

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# 14584-0819 4. Project Manager: Yiamis Efstathiou

2a. Project Address:201 Warren street, New York,NYl 0282 4a, Investigator:Mark Nakhumovich

3. Date: 6. Building Name: P.S. 89M 8. Turnaround Time: 9. Comments (Field): □ STAT □ □ 72 HRS □ OTHER Analyzed all of them for fiberglass T. Sampling Areas: 10. Time in / Time out: □ 6 HRS 048 HOURS O NORMAL

SAMPLE ID MATERIAL LOCATION FLOOR RESULTS

H.A.# NUMBER DESCRIPTION NUMBER

P.S. 89M-6/21/02- Xi Fiberglass- 2-1 Settled Dust aja P.S. 89M-6/21/02- Fiberglass- JT, Settled Dust P.S. 89M-6/21/02- ^3 Fiberglass- <2^^ P.S. 89M-6/21/02- Settled Dust It JUo Alt Fiberglass- 7. t( Settled Dust P.S. 89M-6/21/02- Sb" Fiberglass- 7^ Settled Dust P.S. 89M-6/21/02- R 3o2 cLG Fiberglass- Settled Dust P.S. 89M-6/21/02- ItSof Fiberglass- Settled Dust P.S. 89M-6/21/02- Fiberglass- '2^ Settled Dust P.S. 89M-6/21/02- Fiberglass- 7,4 Settled Dust P.S. 89M-6/21/02- R324 Fiberglass- Settled Dust CHAIN OF CUSTODY P ease call Project Manager 646-772-1155 17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal: FIELD WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: 27. Comments (Lab): 24a. Analyzed By: Ay' — '/u/e 24b. Analyzed By: 24c. QC By:

Filename: P.\USERS'DATA\WP96\WP\FORMS\NY-13.XLS Form NY-13

CONFIDENTIAL, CITY_21MC100_0 03471589 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000177214

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NYC-WTC_000177214Source: NYC Law Department, mirrored locally

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Chain of custody form and data sheet for bulk asbestos samples collected at P.S. 89M on Warren Street during AHERA reinspection.

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