z hAMlUNSULIANIS CHAIN OF CUSTOD OR ASBESTOS AIR MONITORING Z
o 35-40 36th Streel rA o
Long Island City
i New York, 11106
CLIENT:-
PROJECT:
SAMPLING DATE:
ADDRESS: F
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o Tel: 718)729-1997 c
o Fax; 718)729-1^76 CT
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00 FIELD DATA LAB ANALYSIS "0
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FLOW FLOW FIBERS FIBERS
SAMPLE E O TIME TIME VOLUME ^XASSEUE O
TYPE LOCATION BEF. AFTER PER PER LAB ID# o
ID# S R IN OUT (liters) 25MM) 37MM o
(Ipm) (Ipm) FIELD CC c
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TEST METHOD;
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SAMPLE TYPE: A=BACKGROUND, B=PREABATEMENT. C=DURING ABATEMENT, D=POST-ABATEMENT
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E=0UTSIDE WORK AREA, F=INSIDE WORK AREA, G=MICROTRAP EXHAUST DISCHARGE </,
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K U=DECONTAMINATION FACILITY, l=CRITICAL BARRIER, J=OUTSIDE BLDG^K^f lELD BLANK
I L^AIR QUALITY, M=COMPLIANCE MONITORING <_
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g TYPE OF RESPIRATORS: —T= HALF FACE. 2 = PAPR, 3 = TYPE C, 4 = OTHER (SPECIFY).
2 TYPE Of^ WORK; 1= BLDG DECON, 2 = PLASTICIZING, 3 = GROSS REMOVAL. 4 = GLOVEBAG. 5 = CLEANING.
6 = ENCAPSULATION, 7 = BAGOUT, 8 = OTHER (SPECIFY):
'o TECHNICIAN:^,^^4-^ ROTAMETER PAGEv^ OP'S-
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CHAIN RELINGUISHED BY. COMMENTS: RECEIVEDATLABBY: pG
CT OF METHOD OF SHIPMENT: SAMPLE CONDITION UPON RECEIPT;
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4^6 ;USTODY DATE/TIME: DATE/TIME: A VT )
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