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Bulk Sample Data and Chain of Custody, P.S. 89M

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Chain of custody form and data sheet for bulk asbestos samples collected at P.S. 89M on Warren Street during AHERA reinspection.

NYC-WTC_000178587–000178590
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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 RErNSPECTION 3. Project# 14584-0819 4. Project ManagerYiannis Efstathiou

2a. Project Address:201 Wanen street, New York,NY10282 4a. Investigator-.Mark Nakhumovich

5. Date: 6. Building Name: P.S.89M 8. Turnaround Time: 9. Comments (Field): □ stat O □ 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- // Fiberglass- // Settled Dust P.S.89M-5/24/02- Fiberglass- /'2 Settled Dust P.S.89M-5/24/02- fl Fiberglass- fi, Settled Dust P.S.89M-5/24/02- fi- soy Fiberglass- Settled Dust P.S.89M-5/24/02- Fiberglass- Settled Dust P.S.89M-5/24/02- /6 Fiberglass- // Settled Dust P.S.89M-5/24/02- /7 Fiberglass- Settled Dust P.S.89M-5/24/02- Fiberglass- Settled Dust P.S.89M-5/24/02- >1 Fiberglass- Settled Dust P.S.89M-5/24/02- Fiberglass- 'I J 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 f ' US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signatuje: 25. Date: 26. Time: 27. Comments (Lab): 24a. Analyzed By: \ C (Pl uQ.

24b. Analyzed By: 24c. QC By:

Filename: P:\USERS\DATA\WP96\WP\FOW'4S\NY.13.XLS Form NY-13

CONFIDENTIAL, CITY_2IMCl00_001902507 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008 NYC-WTC_000178588

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NYC-WTC_000178588Source: NYC Law Department, mirrored locally

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