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Asbestos bulk analysis chain of custody form

Machine-extracted title · confidence 95%

Blank chain of custody form for asbestos bulk analysis samples from the City of New York Asbestos Control Program.

NYC-WTC_000181904
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Scanned page image, NYC-WTC_000181904
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OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

•» CITY OF NEW YORK department of environmental protection ASBESTOS CONTROL PROGRAM 59-17 JUNCTION BOULEVARD CORONA, NY 11368

CHRISTOPHER WARD, P.E. COMMISSIONER

ASBESTOS CONTROL PROGRAM BULK ANALYSIS CHAIN OF CUSTODY

hicideiil ^0.I.; Date Sampled

Premise: I ime:

Boro:

Inspeelor:

TURNAROUND TIME: 24HRS 48HRS [ ) 1 WK [ ] 2 WKS [ ] 4 WKS t 1

I SAMPLE bSAeR • > - • description'. . •< , . -LOCATION SAMPLED' ; lab'id

1. 7t) 2 . ___________ 7To 4 .

5 .

6.

7,

8.

9. 10 ,

ANALYSES REQUESTED: Asbestos PLM [ Asbestos TEM [ ]

. .. .accepied^b;.: •' r - CCMMENTS , •

FHINT

SIGN c P

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p

s

CITY_DEP_WORBY_CANNATA_SUBP__000130428

NYC-WTC_000181904

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NYC-WTC_000181904Source: NYC Law Department, mirrored locally

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