NYC-WTC_000186479
Document recording the chain of custody and analysis request for samples submitted from an Edison location.
1 shared non-person entities · 1 shared topics · similarity 0.965
machine-extracted · confidence unavailable · Check page ↗Document / 1 page
Chain of custody form for Edison site samples
Machine-extracted title · confidence 85%Chain of custody and analysis request form from STL Edison for environmental sample collection and testing.
NYC-WTC_000178281Page image
OCR text
OCR status: ok · source: pdftotext
NYC 9/11 Public Portal Document
m o STL EDISON 777 New Durham Road o CHAIN OF CUSTODY / ANALYSIS REQUEST h ®ISI Edison. New Jersey 08817 Phone; (732) 540-3900 Fax; (732) 549-3679 Name (for report and invoioe) SarnplersWame (Printed ) i i Site/Proiecl identifeatian i * / PAGE___OF___
_____ AlJJ 7?*dt Company , P.O. # r State (LoMfcn of site): NJ:f~| NY:j^ Other: Regulatory Program; Address A Anafyals Turnaround Tims AHALT^eaeaUESTED [EKTEH-X-EEtjOWTOINDICAlEREaUESll LAB USE ONLY SlanifanlQ Project Ko: Slate □ Rusl Charges AulhDfliEd For
2 Week ^one ~ IVVeek
□(her n 4>/ - Oi No. of. Sample sample Iderrlification I Data Tima Matrix Coni. Numbers z; 50 ft V/o/q3 1!^ /I y X X X X X Y X Qi u:
a 2=. z; o cn Ld ex ao ^euUfeijjQ^Jddls 1/ X X X X X XX s I
c 03 lO o: CD Preservation Used; 1 = ICE, 2 = HCI. 3 = 4 = HNOj, 5 = NaOH Soil: CM 03 e = Other 7 = Other. Waler: CO tQ co I'- CM CO Special Instructions. Water Metals Filtered (YesT^o)? 03
SMI Relinquished by / / Company Date/Time Reel Company I >e u pS I o Company ' Date / Time ic <D CM Relinquished bj/ Company co CD 2)__________ I 2) CM O Relinquished by Company Date / Time Received by Company o CM o CM 03 3)___________ I 3) C3 Relinquished by Company Date / Time Received by Company ’tj’
o o 4)____________________________________ L_ I 4) Laboratory CuiWications: New Jersey (12020), Nev; York (11452), Pennsylvania (60-522). Conneclicut (PH-0200), Rhode Island (132).
NYC-WTC_000178281
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NYC-WTC_000178281Source: NYC Law Department, mirrored locally
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NYC-WTC_000186479
Document recording the chain of custody and analysis request for samples submitted from an Edison location.
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