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Bulk sample chain of custody form, 100 Trinity Place, March

Machine-extracted title · confidence 93%

Chain of custody form for bulk samples from 100 Trinity Place analyzed for fiberglass on March 9, 2002.

NYC-WTC_000178843
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Scanned page image, NYC-WTC_000178843
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NYC 9/11 Public Portal Document > ATC ASSOCIATES INC. A of | > BATCH NO. 9 Page “110 Z BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION 1. Citem: NYC - BOE 2. Project Nam AHERA REINSPECTION 3. Project # 14584-0865 4. Project Manager: Yiannis Efstathiou 2a. Project Address:100 Trinity Place, New York, NY 10006 4a. Investigator:Chacxo Mathew 5. Date: 6. Building Name:M833 8. Tumaround Time: 9. Comments (Field): {[]stat [_]24¢HrS [(] 72HRS [_] OTHER | Analyzed all them for fiberglass 3 wal 3g + fF Sampling Areas: 10. Time in / Time out: - [CJeéurs (Jasuours ([] NorMaAL SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A# NUMBER DESCRIPTION NUMBER * M833-3/9/02- \. . ' Ve he bb ¥) by, \ Fiberglass- 6 \ Settled Dust hea Gave Uw bee Mp . M833-3/9/02- AsdvNciwe F\ses by Shug 2 Fiberglass- 6. Settled Dust ; M833-3/9/02- 4 ' BY ery hele by bee. 3 Fiberglass- ¢°s Settled Dust voy weed i) mA Bob M833-3/9/02- ey \ . -\ ~ j A tt Fiberglass- ©“ Settled Dust 9 Tlesi hal\ws sy og 2 M833-3/9/02- / . QV aside ak. *gom ¥ Lise S Fiberglass- 6% Settled Dust . Qon j a - M833-3/9/02- = g bev. Q\ass worm ew Now t aN xe b Fiberglass- 06 Settled Dust ° M833-3/9/02- . 4 Flo f ewe Elwood q Fiberglass- o"} Settled Dust bs e \ VEX M833-3/9/02- . < % oh 8 _ |Fiberglass- 0 § Settled Dust “— ~ 3 M833-3/9/02- hy + . gf n ~\ ‘ ~ > a “4 Fiberglass- 09 Settled Dust ar ees 3 dy ove VRS / M833-3/9/02- Fiberglass- Settled Dust CHAIN OF CUSTODY 17. Relinquished By: 18. Date:19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal: : . ape . FIELD (kf ns al a\o4 Get 3/9 ow N30V4 |[wacKIN | - / mag US MAIL FED-X OTHER LAB INFORMATION 24, Name and Signature: 25. Date:[26. Time: 27. Comments (Lab): 24a. Analyzed By: Ww Weglre yr 24b. Analyzed By: yi / 7 i 24c. QC By: f Filename: P:\USERS\DATA\WP96\WP\FORMSINY-13.XLS Fom NY-13 - CONFIDENTIAL, — : CITY_21MC100_003390974 SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008 NYC-WTC_000178843

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NYC-WTC_000178843Source: NYC Law Department, mirrored locally

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