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

NYC 9/11 Public Portal Document

Page 3 of M- 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# 14584-0823 4. Project Manager: Yiawiis Efetathiou

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

5. Date: 5. Building Name;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; C. V. □ 6 HRS 048 HOURS □ NORMAL F-O i H

SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER PS234M-4/13/02- O-oT- Fiberglass- X\ Settled Dust PS234M-4/13/02- -toe. m AA 1 Fiberglass- d. x Settled Dust PS234M-4/13/02- C-\®.SS w -zK "lt-'S 2.3 Fiberglass- Settled Dust 1- PS234M-4/13/02- ■J-M Fiberglass- XM- Settled Dust PS234M-4/13/02- N J\ X \ 'L xot) ■xs Fiberglass- PS234M-4/13/02r Settled Dust XZj Fiberglass- Settled Dust T- PS234M-4/13/02- C-^^SS '□.'oX 3-^ Fiberglass- Settled Dust 3 PS234M-4/13/02- 3-3 Fiberglass- PS234M-4/13/02- Settled Dust O\^ss At "ixS .. •S /2A Fiberglass- Settled Dust PS234M-4/13/02-

^0 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 mVoI «■ X-. WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 126 Time: 27. Comments (Lab): 24a. Analyzed By: 62--^ > 24b. Analyzed By: ! / 24c. QC By:

Filename: P:\USERS\DATA\WP96\WP\FORMS\NY-13.XLS FoimNY.l3

CONFIDENTIAL, CITY_21MC100_003394766 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000178668