NYC 9/11 Public Portal Document
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ATC ASSOCIATES INC. BATCH NO.
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT INFORMATION
1. Client: NYC - BOE 2. Project Nam AHERA REINSPECTION 3, Project# 14584-0819 4. Project Manager:Yiannis EfsUthiou
2a. Project Addres5:201 Warren street, New York,NY102S2 4a. lnvestigator:Mark Nakhumovich
5. Date: 6. Built ingName: P.S.89M 8. Turnaround Time: 9. Comments (Field);
□ STAT □ □ 72 HRS □ OTHER Analyzed all of them for fiberglass
,7. Sampling Areas: 10. Time in / Time out:
□ 6 HRS □ 48 HOURS □normal
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER DESCRIPTION NUMBER
P.S.89M-5/24/02-
01 Fiberglass- ( Settled Dust h'6i2^
P.S.89M-5/24/02-
01^ Fiberglass- 2. Settled Dust
P.S.89M-5/24/02-
03> Fiberglass- Settled Dust &'r<pui4p( uot^tyT. C£44'/-&r'
P.S.89M-5/24/02-
Fiberglass- 1/ Settled Dust —
P.S.89M-5/24/02-
or Fiberglass- Settled Dust o(jL^
P.S.89M-5/24/02-
06 Fiberglass- Settled Dust
P.S.89M-5/24/02-
01 Fiberglass- n Settled Dust f
P.S.89M-5/24/02-
OS Fiberglass- Settled Dust
P.S.89M-5/24/02-
Fiberglass- Settled Dust
P.S.89M-5/24/02-
“7 fi/'
¥
Fiberglass- Settled Dust
CHAIN OF CUSTODY
17. Relinquished By: 18. Date; 19. Time; 20. Received By: 21. Date; 22. Time: 23. Method of
Submittal:
FIELD
WALK IN
7 US MAIL
FED-X
OTHER
LAB INFORMATION
24. Name and Signature:, „ „ 25- Date: 26. Time: 27. Comments (Lab):
24a. Analyzed By: A CX-J <70 pus
24b. Analyzed By:
24c. QC By:
Filename; P;\USERS\DATA\WP96\WP\FO1<MS\NY-13-XLS Form NY. 13
CONFIDENTIAL . CITY_21MC100_001902506
SUB,JECT TO PROTECTIVE ORDER NO. 2, SEPT. 2 00 8
NYC-WTC_000178587
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