NYC-WTC_000182525

NYC 9/11 Public Portal Document

Page of . ATC ASSOCIATES INC. BATCH NO. ! zT <

BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION 1. Client; NYC - BOE 2. Project Name: 3. Project 3 19125-0246 4. Project Manager; ANDMcAS ANDR.EO1J

2a. Project Atldress:345 Chambers street. New York, NV 10007 4a. Investigator: A. Andreou / Y. Efstatiiioti

?. Date: 6. Building Name: ii. Turnaround Time: % Comments (Field):

New Stuyvesant HS (M47') □ stat □ 24 HRS □ 72 HRS OTHER 7. Sampling Areas: 10. Time in / Time out: S lOrk U AoctE.% □ 6 HRS QS HOURS ' □ NORjYaL QjlIL. SAMPLE MATERIAL LOCATION damage EXPOSURE RESULTS I.D.# NUMBER DESCRIPTION \7N & ACCESS

Lost NAMF4tS i^x2rA -THIS? Non □ ( q-' H M L

- n1 c. ii srU i)£re:jtiy 1 CU^zHJtCLLSZQ H M L

Ulf -r-a^ t TO J -03 Ifh^ H M L

sejiioc: H M L

r I HvAo H M L

DJST pizz?M — Ql^S-OTiU - i -OC: OzViT tf-'Z- ___ H M L

TKts; J?y Dfet sAr'iaes NoaSC I TcHe LT^TSiW-Lz? TO H M L

i^rjsczun' Djst a -£>8 b-tig3R H M L

dustSAnfLeS a ’ iq/ZlICCMj H M L

a CHAIN OF CUSTODY HO T(-tlS~ — H M L I 17 Relinquished By: IS. Date: ■19. Time: 20. Received By. 21. Dare: 22. Time: 23. Method of' Submittal FIELD 3^ ^1^1 jo I t-'Tofty walk in US MAIL FEPrX OTHER

LAB INFORMATION 24 Name and Signature: 25 Date' 2b Time; 27 Comments (Lab;;

24a.' Analvaed By. H zA f

24b. .Analyzed Bv

24c. OC By;

Filename, P:\UScRS\DATA’AVP9bAVP\rORMS\NY-13 XUS Fonn NY -13

CITY_21MC100_003099158

NYC-WTC_000182525