NYC 9/11 Public Portal Document
Page J- of
TC ASSOCIATES INC. BATCH NO.
BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM
PROJECT INFORMATION
1. Client: NYC - BOE 2. Project Nam AHERA RBINSPECTION 3. Project# 14584-0864 4. Project ManagerYiannis Efstathiou
2a. Project Address;9C Trinity Place, New York, NY 10006 4a. Investigator:Yiaiims Efstathiou
"s', bate: 6. Builc ing Name:M894 8. Turnaround Time: 9. Comments (Field);
Q stat Q 24 HRS □ 72 HRS □ OTHER Analyzed all them for fiberglass
7. Sampling Areas: 10. Time in / Time out:
□ 6 HRS Q 4g HOURS □ NORMAL
SAMPLE ID MATERIAL LOCATION FLOOR RESULTS
H.A.# NUMBER description NUMBER
M894-3/7/02-
Settled Dust
Fiberglass-Q f
M894-3/7/02-
-Zj-UL
Fiberglass- Settled Dust
M894-3/7/02-
Fiberglass-Q::^ Settled Dust f__
M894-3/7/02-
Fiberglass-O/|-
M894-3/7/02-
Settled Dust
3rd fleer kcrKtYZcy
^iooA
Fiberglass- Settled Dust
M894-3/7/02- floo/ Aallarrsutj
Fiberglass-Q^ Settled Dust
M894-3/7/02- fhof hallajc^
Fiberglass-^'j Settled Dust
M894.3/7/02-
Fiberglass-O^
M894-3/7/02-
Fiberglass-(2)Q
Settled Dust
Settled Dust
0
-
M894-3/7/02-
Fiberglass-/Q Settled Dust 00 r^)
CHAIN OF CUSTODY
17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of
Submittal:
FIELD
WALK IN
2 US MAIL
FED-X
OTHER
LAB INFORMATION
24. Name and Signature: 25. Date: :26. Time: 27. Comments (Lab):
24a. Analyzed By; /O /<///
I
24b. Analyzed By:
24c. QC By:
Filename; F;\USERS\DATA\WP96\WP\FORMS\NY. 13.XLS Foitb NY-i3
CONFIDENTIAL, CITY_21MC100_003459178
SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008
NYC-WTC_000179423
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