Survey data sheet for bulk and wipe samples, undated

NYC 9/11 Public Portal Document

TURN AROUND TIME; ca US RUSH □ 6 HRS □ 24 HRS □ OTHER ■~s.

IQ tn m PAGE /S OF CD T) emteque URVEY DATA SHEET / BULK & WIPE SAMPLE LOG l\3 CB O

hj (S (3 EMTEQUE PROJECT NO.: Ik LOCATION(S) SURVEYED : ft.

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< PROJECT SITE: vaAfi^ SCOPE OF WORK: s § ro to INVESTIGATOR: INSPECTOR: OF INSPECTION: I ro OD

FUNCTIONAL SPACE SAMPLE # ASSESSMENT ASBESTOS o

OR HOMOGENEOUS QUANTTTY CONTENT (S <s (JI FLOOR AREA DESCRIPTION ASSUMED HID MATERIAL DESCRIPTION (LF/SF) COND FRIAB % co 1, 2, 3, 4, F PLM: ^4z^/ 5,6,7 NF GMDP TEM; TTxX 5,6,7 GMDP NF TEM: -I. 2. 3. 4, 5,6,7 F PLM; // GMDP NF TEM: 1, 2, 3, 4, (^rz" 5,6,7 F PLM; m NF TEM: z G MD P tn 1 2, 3. 4, 5,6,7 F PLM: s 7 G MD P NF TEM: i> z I 1,i3,4, PLM; 1> 5,6,7 F NF TEM: GMDP E> 1,2. 3, A z r\) w S /Y/Z72X. zr? - ,A/XZ 5,6.7 GMDP F NF PLM: TEM: 1, 2, 3, 4, rj kD ^[ic. 4> 5,6,7 F NF PLM; TEM: Q G MD P 1. i 3, 4. PLM: Q 5,6,7 F o NF TEM; GMDP Si “ PHYSICAL COKOinON ASSESS MB<r FRIABLE PLM - POLARIZED LIGHT TEM-TRANyaiSSION ELfCTP.OJJ NSCROSCOPY NY50OL INSPECTOR: CEKnnCATE NO.: ^ZtimE: %; Ci I CanagBloi OjifartH Dsejsl ftliHi B 2 Oant^ FiLUi Sitbing AOI Yes(Y1 RaiNQUISI .DATE:. THLEPHONE NO. : (2)2) 631 .SOM -ADDRESS'eni!9(»Je &xporBaon ________ soaSntati A(wii». aite 3KI. ny.ny looia_______________

li I J llpitarrt/ Oarajsd F«* HjAmrj ACM Sk,(N) DATE: ______________ TIME:______________ l.A visod deJenn'natfonot iccessiWe susp&ctmaedfef&aM oooditcn. 40a((«^vajiti»*F5uuasdFn:ti)Ha; KM RECEIVED B 2. CottacI MA earrtplas a) ftusfiect bis'lcing rietafiats. D £2) 5ACSU VithfoInlU ki Caic«« « KEU viti piurtS kt SmTicsrt RELINQUISH tyBLF 2D 2001 DATE;. TIME: X A phyafcaS'Ffefx) P/eairS" tesl lot dKrnnlrinB WaMity and amaitico. E" m §1 r 7 FiUb o «Kp>d ICSM 4. AsscssmSTt 0# sjsped tnatZa and non-friaite fnatertots and (ocatcna. 6. Quan^ ttia smounto) euapect tnate/ials In Oisii teapedira locsdona. m I Q G - Good / IM) - Mrwt Odmags / P -Foor o hj RECEIVED BY;, DATE: ' TIME:. 6. SubmH bu* t»npte5 ftx andyBS by PLM and/or TBd MaSiod. o 7. Bulk Sample JocaTxrra and iiEpad matenats swe identified cn tie O ! hO FELDHqTSS: B^ipropneJe twUdlng noor ptan diagraa wtm mo sampte ruciber. CO ANALYZE; >^ALL □ STOP AT FIRST POSITIVE 6. A Chain o( Oatadyraccrd erxjjrif €<tiod ma kompPee to die taa>crefEry. 9. Do not prep fcrTEM analysis unless the sample □ PLM □TEM will be analyzed TOW. - o Ui

NYC-WTC_000182381