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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
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Scanned page image, NYC-WTC_000177258
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OCR status: ocr · source: ours

NYC 9/11 Public Portal Document CONFIDENTIAL. SUBJECT TO PROTECTIVE ORDER NO. 2: SEPT. 2008 TRC Client New York City Law Department Dafe: 2-20-02 WIPE SAMPLE INFORMATION R02020746 DIOXIN WIPE SAMPLE DATA AND CHAIN OF CUSTODY FORM , Projaci Name & Address: TRC Fleld Representative: Page 100 Church St. WEKEN GAGNE Requested Turnaround Time: TRC Project Manager: ( NITIN DAVE OFFICE PHONE: 212-563-3933 2 TRC Project No. 35052.0000-0000 = Z _or 2 CELL PHONE: 917-549-3382 Area Sampled Sample Number, (74022302ANI5O JG02200ZDV503 : TG0220020N601 1JG0220020W60z •J602200ZDW603 -BLANK' _BLANK Surface Doscrlption. METAL METAL DETAL WOOD NOOP Tolal Area IM2 Floor 5 5 6 4 6 Sample Locatlon Room/Area Dascription Top of Ft Kitchen catrtep Filling CABNEt TM 5-174 op o incocton unit: 6-100 Jop of Desk PM 6-196 TOP of TABLE LBRARY NOT USTER eN CHAIN - 9O NOT UISTER ON CHAN JO PSC Analytical Services 6109219667 SPECIAL INSTRUCTIONS TO LABORATORY Fax Results To (Name) NITIN DAVE at (Number) 212-349-4648 CHAIN OF CUȘTODY DOCUMENTATION AND LABORATORY INFORMATION Relinquished BY Time Recolved By Date TThne 6:50 Fudiye TH. g.Daren 2/21/02 915 CITY_21MC100_014658869 Melhod of Submiltal Fleld Walk in Us Maif Fed-Ex Other Commenis (Lab) Name and Signalure: Analyzed By: Analyzed By: QC By: Date Time 1362 NYC-WTC_000177258

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NYC-WTC_000177258Source: NYC Law Department, mirrored locally

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