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Asbestos Microvac Chain of Custody Form, July 2003

Machine-extracted title · confidence 95%

Chain of custody form documenting the collection and transfer of asbestos microvac samples for the Law Department.

NYC-WTC_000177313
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Scanned page image, NYC-WTC_000177313
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NYC 9/11 Public Portal Document

G3cmo^ ASBESTOS MICROVAC DATA AND CHAIN OF CUSTODY FORM Client Project Mame & Address; TRC Field RApresentative: Page New York City Law Department 100 Church St. Nazar Agahari 1 of 1 15atei Requested Turnaround Time; TRC Project Manager: TRC Project No. 07/17/03 OFFICE PHONE; 212-563-3033 3 'Z.O *7 3 WIPE SAf^LE INFORMATirtKJ Area Sampled Sample Locaflon Cenlimticrs Tola] Area Sarripls Number. Surface Descriplion. (Square CM) Floor RoQiTi/Area Description o 74 OY/7^ o z m 10 X___ 18_ 100 SCM 4th O m z FZWf 'i-i 10 X___ 10 /^/QC>K /epdz/^c w oi= 'i i'/’ey c CD rop 10 X___ 10_ C/7A. ffoof-' m O o7 Toi^ Cf' 0^i// Lj S i£>C> .7/jl CJ7I-7OJ o b / 'tot 1} tz. 10 x___ 10_ C/-fA 5 Tor op 7_________ _ 3m 3toYt7Y7Yo3 J0 x__ 10_ pjody ^CiiirK O H 43^ Al ^05-' 7 e>r or- /}UC^-P ■______________ m O b r- C-C/ li'rig' 10 X 10 /S/eJar □J o m £1^ ZSA//^ %• jj z p /-I JQ x__ -|0_ co m c TiJ V ■ r pT -V I^X___ 10_ § 10 X___ 1D„

SPECIAL INSTRUCTIONS TO l_ASORATORY cn Fax Results To (Name) p Q al (Number) 212-221-7840 gjjAINO^CLiSTODY DOCUMENTATION AND LABORATORY INFpRMATlON o ReJIfiquished By --.■■V-Time Date I------------ ----------------- ^eceiverJ^ Da' Time Method of Submittal Comments (Lab)

'to Field □ ANALYZE TEMASTW 5755 C/-z7/.'S5 f5>3. Walk In 7)o If to "7/'('//'■ O II. US Mail n Name and Signature: ~~ I Date Tims Fed-Ex u Analyzed By;

O) oi III. Ollier □ Anslyzed By: CD QC By; CO CD

NYC-WTC_000177313

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NYC-WTC_000177313Source: NYC Law Department, mirrored locally

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