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CHAIN OF CUST /Y FOR ASBESTOS AIR MONITORING z
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Long (stand City CLIENT; Dc^^/4^ SAMPLING DATE: co
New Yofk, 11106 PROJECT; y / ADDRESS: 1
po Tel: (718)729-1997 "0
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o Fax:(718)729-1876 / 4?/ o'
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FIELD DATA LAB ANALYSIS I o
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FLOW FLOW FIBERS FIBERS O
SAMPLE E O TIME TIME VOLUME TIE o
TYPL LOCATION BEF. AFTER PER PER lAB ID# o
ID# S R IN OUT (liters) 3ZMM c
(Ipm) (Ipm) FIELD CC
P K AcieaMi 3
CD
lETHOD 3
I IF
--------------------- --- --- ---------------- ♦------ -------------------------------- 7..,..-,,*^-,
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PCI TEM
2 LF lb" /S' lb 'C'/t' >i^ 2.
5 lE /s'’ 75" IS 3
TURN-AROi IME:
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IMEDIATE
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LE[ tSi/icL 6v ^^£1 /?
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12-HOUR
24-HOUR
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24-HOUR
7 L£ Ik /S Co* a \ 7
OTHER:
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£ 15^ /4‘d I s IS 1
ANALYST:
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If DATE OF ANALYSIS:
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TWEOf- ANALYSIS.
o SAMPLE lYPL A=DACKGROUNI). B^PREABATEMENT, C=DURING ABATEMENT. D=POST-ABATEMENT
H
E=OUTSIDE WORK AREA, F=INSIDE WORK AREA, G=MICROTRAP EXHAUST DISCHARGE:
H=DECONTAMINAriON FACILITY, l=CRITICAL BARRIER, JOUKSIDL BLDG., K=FIELD BLANK
LO L= AIR QUALITY, M=COMPLIAMCE MONITORING
S TYPE OF RESPIRATORS: 1 = HALF FACE, 2 = PAPR, 3 = TYPE C, 4 = OTHER (SPECIFY):
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1= BLDG DECON, 2 = PLASTICIZING, 3 = GROSS REMOVAL, 4 = GLOVECAG, 5 = CLEANING,
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6 = ENCAPSULATION, 7 = BAGOUT, 0 = OTHER (SPECIFY):
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o TECHNICIAN H ROTAMETER: K 7 // PAGE { OF )
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co CHAIN RELINGUISHEO BY: COMMENTS: RECEIVED AT LAB BY B
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cn OF METHODOF SHIPMENT SAMPLE CONDITION UPON RECEIPT:
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