NYC Law Department release
Independent mirror · updated as the City releases more · v1.3.2
☕ Buy me a coffee
← Document results/Unboxed/No folder label
Document / 1 page

Chain-of-custody form for analytical request

Machine-extracted title · confidence 80%

Legal chain-of-custody document for submitting samples to [name] Services for analysis.

NYC-WTC_000178043
Page image
Scanned page image, NYC-WTC_000178043
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

t^riMiN-ur-uui) I uuY / Analytical Hequest Document Analytical" The Chain-of-Custody Is s LEGAL DOCUMENT. All relevant fields must be completed accurately. www.pacalaln.rain Required Client Intormalion: RetMitTo: -T SeCtlOfl B I Page: j of l 625144 Required Ghent Information: Section A _______ cjCV>AA-a^ <_o V\iA To Be Completed by Pace Analytical and Client SeCtiOH C Company Copy To; ■Tr Quote Reference: ypic. Client Information (Check quote/contracl): Address Invoice To: Requested Due Date; TXT Project Manager:

PO, Project»:

Project Name: • Turn around times less than 14 days subject to laboratory and contractual obligations and may result In a Rush Turnaround Surcharge. Profile #: /’PST') / 7 7^ Turn Around Time (TAT) in calendar days. Phone Fax Project Number. Requested Analysis:

Section D Required Client Information: Valid Matrix Co o Q Preservatives CODE LU WATER WT w 5 G SAMPLE ID SOIL OIL SL OL go P * CO G M s One character per box. WIPE AIR WP AR X £ °g „ X O H lU t (A-Z, 0-9 /.-) Sample IDs MUST BE UNIQUE TISSUE OTHER TS OT I mm/dd/yy * 5 I I- Remarks / Lab ID H O DI L c e> E 5'^K 'S'. _j>± T3 ?3 2 CD T a O H M 3 M’i 1911 s Ba ISSI w O H Hl < M O O S H| Hl 4

A as g s5 a O ?o a M s H liiEBiilBHiiiiiiai BIMBBBiiHi I a a ■IIIIM^ WMI^BIIW IfiiMiiI lll^■l I 11 ^■L. J1~ "

"3inil IIIIMIIIH M Hl ?a > 7 S ' o 8

9 ■■■■BBBBBBBB

Himi ■lllllll IlBlillSIS W 10 M G H 11

to 12 o o J RELINQUISHED BY / AFFILIATION DATE i TIME ' ACCEPTED BY / AFFILIATION ! DATE TIME SHIPMENT METHOD AIRBILL NO SHIPPING DATE JNO OF COOLERS co O

H SAMPLE CONDITION SAMPLE NOTES Temp in *’C 111 O Received on Ice Yi©

I O O Sealed Cooler I AMPLER NAME AND SIGNATURE PRINT Name of SAMPLER; o o Samples Intact 0N SIGNATURE ol SAMPLER: DATESigiwd: (MM/DD/YY) on Additional Comments: z. O fl NAI I ( I f 'f ! I QPr Izpo’ line I ) iMC V' ' Vncn. )• co

NYC-WTC_000178043

OCR can misread numbers and units. Confirm readings against the page image before using them.

NYC-WTC_000178043Source: NYC Law Department, mirrored locally

Related records

Browse subjects →

Ranked by indexed similarity. Reasons describe shared subjects and filing context; check the source records.

Same-box records

Filed elsewhere

No available related records indexed in this group.

More like this page

Similar subjects in other documents. Similarity does not establish the same event, measurement or conclusion.

Others also read

Readers open these alongside this record — through an Ask answer, the same folder, or indexed similarity. Not a claim they are about the same event.

Compare copies and versions →