NYC-WTC_000182525

NYC 9/11 Public Portal Document

of ATC ASSOCIATES INC. BATCH NO.

BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION I. Client: NYC - BOE 2. Project Name. J. Project.# 19123-0246 4. Project Manager: .ANDR.E.AS ANDREOU

2u. Project Address:345 Chambers street, New York, NY 10007 4a. Investigator: A. .Andreou / Etstathiou

?. Date: b. Building Name: ii. Turnaround Time: iL Cumments (Field): yi New StLiyvesant HS (M477) Q stat □ 24 HRS □ 72 HRS OTHER /jNAcV2Z:O2) =121 7. Sampling Areas: S IO Jk U /YdCnc-S □ 6 HRS Qs HOURS Q NORMAL 10. Time in / Time out:

' sample MATERIAL LOC.ATION DAMAGE EXPOSURE RESULTS I.D. # NUMBER DESCRIPTION (SpG^ Y/N Jt .ACCESS

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D057 Sac At: s /aJ -7*^* H M L ___________________ _________ £07 SaHPlK, H M L / ^1 -30 J CHAIN' OF CUSTODY i7. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 2j. Method of Submittal: FIELD MIcvjW' W,ALIC IN US MAIL FED-X other'

LAB information 24. Name and Signature- 25. Date: 26 Time: 27. Cumments I Lab):

24?,. Analyzed By A- AijJi. / 24b. Analyzed By; :4c. QC By:

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CITY_21MC100_003099160

NYC-WTC_000182527