NYC 9/11 Public Portal Document
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:Yiannis Efstathiou
2a. Project Address:201 Warren street, New York,NY10282 4a. Investigator: Yiannis Efstathiou
5. Date: 6. Building Name:P.S.89M 8. Turnaround Time: 9. Comments (Field):
□ STAT □ 24 HRS □ 72 HRS Q OTHER Analyzed all of them for fiberglass
7. Sampling Areas; 10. Time in / Time out:
□ 6 HRS Q 48 HOURS Q NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER DESCRIPTION NUMBER
PS89M-4/5/02-
Fiberglass-^/ Settled Dust Ccn-lCtCp
PS89M-4/5/02-
Fiberglass-^_^ Settled Dust
PS89M-4/5/0^
I'de
Fiberglass-Q^ Settled Dust crj/ST/vl?
PS89M-4/5/02-
Fiberglass-(^J. Settled Dust
PS89M-4/5/02-
Fiberglass-^^ Settled Dust i On S'
PS89M-4/5/02-
Fiberglass-^QZ Settled Dust
PS89M-4/5/02-
Fiberglass-Q-x Settled Dust
PS89M-4/5/02-
Fiberglass-Q^ Settled Dust Y-f/rr^r aYI
PS89M-4/5/02-
Fiberglass-
PS89M-4/5/02-
Q Settled Dust dot Ab
Fiberglass- jQ Settled Dust cr<
CHAIN OF CUSTODY
17. Relinquished By: 18. Date: 19. Time: 20. Received By. 21. Date: 22. Time: 23. Method of
Submittal:
FIELD
c
WALK IN
US MAIL
FED-X
OTHER
LAB INFORMATION
24. Name and Signature: 25. Date: 26. Time: 11. Comments (Lab):
24a. Analyzed By: U/H.i I 4-^
24b. Analyzed By:
24c. QC By:
Filename: P\USERS\DATA\WP96\WP'FOILMSW-I3 XLS FormNY-lJ
CONFIDENTIAL, CITY_21MC100_003473772
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000177689
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