NYC 9/11 Public Portal Document
Page of
ATC ASSOCIATES INC. BATCH NO. ./ , .
BULK SAMPLE DATA AND CHAIN OF CUSTODY LOK)I
PROJECT INFORMATION
1, Client: NYC ■ BOE 2 Project Nam AHERA REINSPECTION i. Project# 19125-0246 4. Project Manager;
2a. Project Address:345 Chambers Street, New York, NY 10007 4a. Investigator Hcrant Antonyan
5. Date; 6? Building NametStuyvesant 8. Turnaround Time: 9. Comments (Field):
HS (M477) □ STAT 0 24 HRS Q 72 HRS 10OTHER Analyzed all them for fiberglass
^^5X3/^ 7, Sampling Areas; Entire
Os HRS O ‘*8 HOURS O NORMAL
10. Time in / Time out;
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.» NUMBER DESCRIPTION .NUMBER
M477-
/ Fiberglass Bulk - Settled Dust
M477-
a Fiberglass Bulk - Settled Dust 3
M477.
3 Fiberglass Bulk - Settled Dust
M477- “
Fiberglass Bulk - Settled Dust
M477 -
Fiberglass Bulk - Settled Dust a
Zi;?
Fiberglass Bulk - Settled Dust
M477 -
7" Fiberglass Bulk - Settled Dust
M477-
8 Fiberglass Bulk - Settled Dust A>7>
M477 -
3 Fiberglass Bulk- Settled Dust
M477 -
/O
Fiberglass Bulk - Settled Dust nsr
CHAIN OF CUSTOPY/%<,s< /ft
17. Relinquished By: 18- Date: 19. Time: 20. Received By;*^ 21. Date; 22. Time: 23. Method of
.Submittal:
FIELD
walk, in
US mail
FED-.X
OTHER
LAB INFORMATION
24 Name and Signature: 25 Date: 26 Time: 27 (?onmeniE iLabl
24a Analyzed By:
<1
24b Analyzed By
24c. OC By:
Filename P IUSERS1DATA\WPO61WP'FOIIMS\N Y-1J XL5 : CiTii
CONFIDENTIAL, CITY_21MC100_003390230
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000178632
OCR can misread numbers and units. Confirm readings against the page image before using them.