Fiberglass bulk sampling chain of custody, P.S. 234M, Apr 2002

NYC 9/11 Public Portal Document

Page Q.- of K ATC ASSOCIATES INC. BATCH NO.

BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION I. Client; NYC - BOE 2. Project Nam AHERA REINSPECTION 3. Project# 145844)823 4. Project Manager:Yiannis Efstathiou

2a. Project Address:292 Greenwich street. New York,NY10007 4a. InvestigatorChacko Mathew

5. Date; 6. Build ng Namc:P.S.234M 8. Turnaround Time: 9. Comments (Field); . □stat □ 24 HRS □ 72 HRS □ OTHER Analyzed all of them for fiberglass 7. Sampling Areas: 10. Time in / Time out; □ 6 HRS □ 48 HOURS Q NORMAL U lO /(H • t»>

SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER PS234M-4/13/02- \>J<SY tA.e*”' G,v\A.«c.r^ Ca_ Fiberglass- U Settled Dust I PS234M-4/13/02- tz Fiberglass- VV Settled Dust 1 /(//I PS234M-4/13/02- ’5 Fiberglass- ‘5 Settled Dust I PS234M-4/13/02- I IF Fiberglass- Settled Dust PS234M-4/13/02- '1O5.V-. 4^ (X'V 1$- Fiberglass- v r Settled Dust 1 PS234M-4/13/02- It Fiberglass- PS234M-4/13/02- Settled Dust C-\‘*SS /U4 n Fiberglass- CJ Settled Dust I PS234M-4/13/02- Fiberglass- I § Settled Dust -i^t ‘It \ aJA) PS234M-4/13/02- \n Fiberglass- Settled Dust PS234M-4/13/02- Fiberglass- XT) Settled Dust X. CHAIN OF CUSTODY 17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal: FIELD (X—‘ Ml isl 01- WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: n. Comments (Lab): 24a. Analyzed By: 24b. Analyzed By; 24c. QC By:

Filename; P:\USERS\DATA\WP96\WP\FORMS\NY-I3.XLS Form NY-13

CONFIDENTIAL, CITY_21MC100_003394765

SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000178667