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Chain of custody for bulk asbestos sample, M894, Oct 2001

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Form documenting the collection and chain of custody for a bulk asbestos sample at building M894 (90 Trinity Place) for AHERA reinspection.

NYC-WTC_000178802
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NYC 9/11 Public Portal Document

Page i of 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# 14584-0864 4. Project Manager:Yiannis Efstathiou

2a. Project Address:90 Trinity Place, New York,NY10006 4a. Investigator: Yiannis Efstathiou

5. Date: 6. Build ng Name:M894 8. Turnaround Time: 9. Comments (Field): □ STAT O □ 72 HRS □ OTHER Analyzed all of them for fiberglass 3 ’Mo; 7. Sampling Areas; □ 6 HRS 048 HOURS □ NORMAL 10. Time in / Time out:

SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER M894-5/2/02- Fiberglass-^ f Settled Dust M894-5/2/02- Fiberglass- Q9 M894-5/2/02- Settled Dust /a Fiberglass- Q;? M894-5/2/02- Settled Dust Mu Fiberglass- q cL M894-5/2/02- Fiberglass- 0$^ Settled Dust

Settled Dust MU- M894-5/2/02- Fiberglass- Settled Dust AM M894-5/2/02- Fiberglass-^j£ Settled Dust M894-5/2/02- Fiberglass-^^ Settled Dust MU /d4 M894-5/2/02- V / Fiberglass- O y Settled Dust M894-5/2/02- Fiberglass- Settled Dust . . s=s=ssssss x,<i6 CHAIN OF CUSTODY 17. Relinquished By; 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal:

ci FIELD WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: 27. Comments (Lab); 24a. Analyzed By: /o /ZZY 24b. Analyzed By: 24c. <JC By:

Hlmanie: P \USER.S'DATA\WP96\WP\FORMS\NY-13 XLS Fumi NY-13

CONFIDENTIAL, CITY_21MC100_003390710 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000178802

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NYC-WTC_000178802Source: NYC Law Department, mirrored locally

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Chain of custody form and data sheet for bulk asbestos samples collected at P.S. 89M on Warren Street during AHERA reinspection.

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