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
1. Client: NYC - BOE 2. Project Nam AHERA REINSPECTION 13. Project # 14584-0819 4. Project Managcr:Yiannis Efstathiou
2a. Project Address:201 Warren street, New York,NYl 0282 4a. InvestigatoriMark Nakhumovich
5. Date: 6. Building Name: P.S. 89M ■ 8 Turnaround Time: 9. Comments (Field):
□ STAT □ □ 72 HRS □ OTHER Analyzed all of them for Fiberglass
7. Sampling Areas: 10. Time in/Timeout;
□ 6 HRS □ 48 HOURS □ NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER DESCRIPTION NUMBER
P.S. 89M-6/21/02-
31 Fiberglass- J f Settled Dust
P.S. 89M-6/21/02-
Fiberglass- Settled Dust
P.S. 89M-6/21/02-
Fiberglass-
P.S. 89M-6/21/02-
Settled Dust a)A
P.H2.C
3*1 Fiberglass- LU Settled Dust
P.S. 89M-6/21/02-
'iS' Fiberglass- 3 Settled Dust
P,S. 89M-6/21/02-
Fiberglass-
P.S. 89M-6/21/02-
Settled Dust /d/)
17 Fiberglass- Settled Dust
P.S. 89M-6/21/02-
S3 Fiberglass- Settled Dust
P.S. 89M-6/21/02-
Fiberglass- 3^ Settled Dust
P.S. 89M-6/21/02-
A
^0 Fiberglass- Settled Dust SSSESKaMHiSS
CHAIN OF CUSTODY Please 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
/?/L/i-7cv. WALK IN
US mail
FED-X
OTHER
LAB INFORMATION
24. Name and Signature: 25. Dale: 26. Time: 27. Comments (Lab):
24a. Analyzed By:
24b. Analyzed By: I
24c. QC By:
Filename: P:\USERS\DATA\WP96\WP\FORMS\NY-13 XLS Form NY-13
CONFIDENTIAL, CITY_21MC100_0 03471590
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000177215
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