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NYC-WTC_000178628

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NYC 9/11 Public Portal Document

Page of . y4ZC ASSOCIATES INC. batch no. -V , <-f’ ("L BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION I. Client: NYt - BOE 2. Project Nam AHERA REINSPECTION 3 Prujeci li I91?5-O24u A PrujcclManagei

?a Project Address:c‘l5 Chambers Street, New York. N't' 10007 4a. investigaiCTii-ierunt Antonyan

Date; 6. Building NumeiStuyyesant S Turnaround Time 9. Com/nents (FiddJ; Z / _ ____________ HS (M477) 0 STAT Q 24 HRS Q 72 HRS 10OTHER Analyzed al! them lor llberolass T Sampling Areas; Entire 10. Time in Time out O 6 HRS 048 HOURS O NORMAL SAMPLE ID MATERIAL LOCATION FLOOR KEsons H.A.« NUMBER DESCRIPTION NUMBER M477- “

Fiberglass Bulk - M477 - Settled Dust x/z Fiberglass Bulk - Settled Dust 3rii^ J M477- 3 Fiberglass Bulk - Settled Dust M477. Settled Dust zfcZazr Fiberglass Bulk - M477- 3" Fiberglass Bulk - Settled Dust ' x'Z M477.-- Fiberglass Bulk - Settled Dust M477. . /33 S • Fiberglass Bulk - Settled Dust M477- . ■ 3 / V 8 Fiberglass Bulk - Settled Dust 3 M477. 5 Fiberglass Bulk - Settled Dust M477 - XT Fiberglass Bulk - Settled Dust CHAIN OF CUSTODY/%<us-e ca//af/e ^4»./>4»^eur uA// 17. Relinquished By; IS. Duie:jl9 Time; 20- Received By; 21 Dale; 22 Time: 23. Method of Submitiol;

I, FIELD walk in US MAIL 3 FED-X OTHER

LAB INFORMATION 24 Name and Signature: 25 paie: 2t. Time: 27 Cammenu {Labi.

24a Analyzed By. ^g-foiuCt BxL 24b. z^nalyzed By: :4c. ex? By:

F.leiianw P ..u5£RS\OATA‘.WP96'.WP'.FOftMS\NY.O -XU

CONFIDENTIAL, CITY_21MC100_003390214 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000178628

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NYC-WTC_000178628Source: NYC Law Department, mirrored locally

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