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NYC-WTC_000178830

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NYC 9/11 Public Portal Document

Page of ■ ATC ASSOCL4TES INC. BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION i. Client: NYC - BOE 2. Projec! Nam AHERA REINSPECTION 3. Project# 19125-0246 4. ^toiect Manager; x / / /

2a. Protect Address;345 Chambers Street, New York, NY 10007 4a. Investigator.Heranf Antonyan

57Datc; 6. Building Name:3tuyvesant S. Turnaround Time: 9. Ctiinments (Field); _________________HS (M477) □ STAT □ 24 HRS □ 72 HRS OTHER Analyzed aii them for fiberglass 7. Sampling Areas: Entire 10. Time in / Time out; □ 6 HRS 048 HOURS O normal SAMPLE ID . MATERIAL LOCATION FLOOR RESULTS H.A.# ■ NUMBER DESCRIPTION NUMBER M477- / Fiberglass Bulk - Settled Dust 4^ M477 - Fiberglass Bulk - Settled Dtist M477 - 3 Fiberglass Bulk - Settled Dust y M477 - Fiberglass Bulk - Settled Dust M477 - Fiberglass Bulk - Settled Dust y tiyy M477- /st/ J y Fiberglass Bulk - Settled Dust mafT"

Fiberglass Bulk - Settled Dust M477 - Fiberglass Bulk - Settled Dust M477 - J Fiberglass Bulk - Settled Dust zUA M477-

Fiberglass Bulk - Settled Dust CHAIN OF CUSTODY//Lay 41 Y zP7c£z>t 17. Relinquished By: IS. Date: 19. Time: 20. Received By: 21. Date: |22. Time: 23. Method of |23. Submittal: FIELD WALK IN US MAIL FED-.X OTHER

LAB INFORMATION 24 Name and Signature: 25. Date: 26. Time; 27. Comments (Lab):

24a. Analyzed By; f ^lyclcz /O 24b. Analyzed By: 7 24c. QC By:

Filcniirac: P:lUSERStDATA\WP9SiWP\FOKMS\NY.|3.XLS Form NY-13

CONFIDENTIAL, CITY_21MC100_003390914 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000178830

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NYC-WTC_000178830Source: NYC Law Department, mirrored locally

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