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CHAIN OF CUSTOD ( FOR ASBESTOS AIR MONITORING CD
35-40 36th Street
§ Long Island City CLIENT: SAMPLING DATE: f ~ 3? 3 Pf pPI “0
NewYork, 11106 PROJECT: ADDRESS: c
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co FIELD DATA LAB ANALYSIS 9L
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BEF. AFTER
VOLUME
FIBERS FIBERS
PER PER LAB ID#
CASSETTE
c
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TYPE
ID# S R IN OUT (liters) 25MM 37MM CD
(Ipm) (Ipm) FIELD CC 3
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ANALYST:
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SAMPLE TYPE: A=BACKGROUND, B=PREABATt:MENT, C=DURING ABATEMENT, D=POST-ABATEMENT •• 2
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H=DECONTAMINATION FACILIT Y, l=CRITICAL BARRIER, J=OUTSIDE BLD^ K^/IELD BLANK
S AIR QUALITY, M=COMPLIANCE MONITORING
o TYPE OF RESPIRATORS: 1 = HALF FACE, 2 = PAPR, 3 = I YPE C, 4 = OTHER (SPECIFY):
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o TYPE OF WORK: 1= BLDG DECON, 2 = PLASTICIZING, 3 = GROSS REMOVAL, 4 = GLOVEBAG, 6 = CLEANING,
I 6 = ENCAPSULATION, 7 = BAGOUT, 8 = OTHER (SPECIFY):
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3 TECHNICIAN: X/ , g-CL ROTAMETER: - Pf PAGE y OF
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OF METHOD OF SHIPMENT: SAMPLE CONDITION UPON RECEIPT: /
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