z KAMCUNSULIANIS CHAIN OF CUSTODY FOR ASBESTOS AIR MONITORING z
o 35-40 36th Sheet
g Long Island City CLIENT: SAMPLING DATE: 0\ o
1^ New York, 11106 PROJECT: ADDRESS: 9,5^ 2)kD6^VlA^ 'HfewkatVak. _k
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o Tel: 718)729-1997 ■0
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' Fax: 718)729-1^76 CT
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FIELD DATA LAB ANALYSIS "0
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FLOW FLOW FIBERS FIBERS
SAMPLE E O TIME TIME VOLUME CASSETTE O
TYPE LOCATION BEF. AFTER PER PER LAB ID# 55MM ; 37MM o
ID# S R IN OUT (liters) o
(Ipm) (Ipm) FIELD CC c
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3
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11u iSbb TE6t MBtHOD: o
3
dX __ M View's oFF\6: J a u PCM
TURN-AROUND TIME:
TEM
J— L vi,\tAa<3»Ti^Lew(p A^n'" IL AX IMMEDIATE
-uM- lU’Pna Q
12-HOUR
VI-ftUlKiA-M U
I oL u Cz»’o|
24-HOUR
u saw n G C- AX A
1^’
.1 7
24-HOUR
OTHER:
OS UbAeLrel^C €x 1^11^
mZ 55.is n \tTO 5^^-' ANALYST:
lit? kZ Hoc I 1 vz> bo
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(2
»ATE OF ANALYSIS:
2 1 -o )
i> I?* IX
TIME OF ANALYSIS:
JA_ JA IS 5^ '3
' ASn Kjl O 1 15 CO
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Q SAMPLE TYPE: A=BACKGROUND, B=PREABATEMENT, C=DURING ABATEMENT, D=POST-ABATEMENT m
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H E=OUTSIDE WORK AREA, F=INSIDE WORK AREA, G=MICROTRAP EXHAUST DISCHARGE
K H=DECONTAMINATION FACILITY. I=CRITICAL BARRIER, J=OUTSIDE BLDG., K=FIELD BLANK 2:52
tnm
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L= AIR QUALITY, M^COMPLIANCE MONITORING
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TYPE OF RESPIRATORS. 1 = HALF FACE, 2 = PAPR, 3 = TYPE C, 4 = OTHER (SPECIFY): Sc -im
TYPE OF WORK: 1= BLDG DECON, 2 = PLASTICIZING, 3 = GROSS REMOVAL, 4 = GLOVEBAG, 5 = CLEANING, >0
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6 = ENCAPSULATION, 7 = BAGOUT. 8 = OTHER (SPECIFY):
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TECHNICIAN. VH^uT • ROTAMETER: VlAH- OX. PAGE I OF X s on
CO
co CHAIN RELINGUISHED BY: ,~ COMMENTS: RECEIVED AT LAB BY: f-fC
OF METHC D OF SHIPMENT: SAMPLE CONDITION UPON RECEIPT:
o USTODY DATETIIME; DATETTIME: 2 /a t *
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