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Dioxin wipe sample chain of custody form

Machine-extracted title · confidence 85%

Chain of custody document for dioxin wipe samples collected from 100 Church Street by the Law Department.

NYC-WTC_000177257–000177258
Page image
Scanned page image, NYC-WTC_000177257
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

fy26T,01^(^ me Client DIOXIN WIPE SAMPLE DATA AND CHAIN OF CUSTODY FORM Project Name & Address: IRC Field Representative: / Page • J s i Naw York City Law Department 100 Church St. 6-66ce 1 of Date: Requested Turnaround Time: TRC Project Manager; NITIN DAVE T TRC Project No. S I •2-20'0^ OFFICE PHONE! 212-563-3033 CELL PHONE: 017-649-3302 35052-00004000*-T. “0 (n

WIPE SAMPLE INFORMATION Area Sampled I Sample Number. Surface Description. Tolal Ares Floor Sample LocaUon_________ Room/Area Description <n n

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a O 2 Tl ,to^2.DvS.2&( 3 toniLA □ cu m 2 2 gyipki gSgai z-t tC I co c CD J >2-‘2oe>^iiyi>so'3 2 LM'^t 2 m o -I Kcmo FiUoq -□ JI 3 lf34rrAi i/Vx Snj-FjooC. .__ to in o /if- -J . T i -I m a t>'2gQ<xpiugea ____________ 3 < m 0 O JI a m ___________ A iSS/SSi iYi<j<^4 wr tn tn JI z p N* ffea' 1 utoggy eiooe TU CO m 1 tn

o IO o s * VpeC CAAI'C I ____ _l 5 RcqAjx s> Iqq to w SPECIAL INSTRUCTIONS TO LABORATORY h- CD Fax Results To (Name) NITIN DAVE at (Number) 212-349-4348 cn Q]

CHAIN OF CUSTODY DOCUMENTATION AND LABORATORY INFORMATION 'J Rellnquiihei Date Tima Date Time Comments (Lab)

^Zo-O). Field □ Walk In IT o US Mall Name and Signature; Dale Time

Tit 4?doi- 11^ Fed-Ex Analyzed By: Other Analyzed By: o QC By; ~ T3 o I W

O) Ul M' 8 8

NYC-WTC_000177257

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NYC-WTC_000177257Source: NYC Law Department, mirrored locally

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