Chain of Custody Form, P.S. 234M Asbestos Inspection

NYC 9/11 Public Portal Document

Page of Ti- ATC ASSOCIATES INC. BATCH NO.

BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION 1. Clieni: NYC - BOE 2. Project Nam AHERA RCINSPECTION 3.. Project i 14584-0823 4. F'roject Manager:Yiannis El'stalhiou

2a. Project Address:292 Greenwich street, New York.NYIOOO? 4a. Investigator Chacko Mathew

5. Dale: 6. Budding Name: P,S.234M 8. Turnaround Time: 9. Comments (Field);

□ STAT □ □ 72 HRS □ OTHER Analyzed all nf them for fiberglass 7. Sampling Areas: 10. Time in / Time out: O 6 HRS r]4S HOURS □ NORMAL O SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER P.S.234M-5/18/02- V 1C4Y Cl AO., V, e\ v4 CCA \ V. n. ' L t 0\ Fiberglass- ) Settled Dust P.S.234M-5/18/02- Cxv-JnA. £r, AF 1 CL Fiberglass- Settled Dust ^7 P.S.234M-5/18/02- Cr.vVev \ CD Fiberglass- Settled Dust Ccr-.c.TeVti StsAe--'-

P.S.234M-5/18/02- CM Fiberglass- lA Settled Dust ( l.\ N O AA Ct n e«^V<. P.S.234M-5/18/02- Y\.'. w.-t V*A 4 Fiberglass- Settled Dust A te. P.S.234M-5/18/02- S ' SM i'Y'. cd. Fiberglass- 4 Settled Dust ■' t.7........ ') iWi> P.S.234M-5/18/02- S SVNH. ' ' Y Vzl Ll a - T\ N c - n V ft V c? Fiberglass- “f Settled Dust C\*' t .J A c tre, V I

AIN P.S.234M-5/18/02- m 1,3 \ Fiberglass- <5 Settled Dust Gnu-,., \ P.S.234M-5/18/02- C ‘'I A 'd -. <- “5 Ao lA c-, I Ms Fiberglass- ^"1 Settled Dust P.S.234M-5/18/02- V-. vs 'l Vt L A o '< 1 V Fiberglass- 10 Settled Dust CHAIN OF CUSTODY 17. Relinquished By: 18. Dale: 19, Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal: FIELD 51 i'<k 777'<.f7 WALK. IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 2S Dale: 26. Time: 27. Comments (Lab): 24a. Analyzed By: '3c 33 24b. Analyzed By: 24c. QC By:

Filename P.\USERS\DATA'-WP96'.WP\FORMS\NY. 13 XLS Form NY-1J

CONFIDENTIAL, CITY_21MC100_003394890 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000178689