NYC-WTC_000187371

NYC 9/11 Public Portal Document

KfS # /o3 Riverpoint, Inc. 7 Hillside Avenue, Suite 100 • New Rochelle » New York 10801-1608 (914) 632-1552 Telephone (914) 632-1558 Facsimile

PCM Air Sample Analysis and Calibration Form Job Number: [QU F = Final Clearance Page p of If Job Name; P= Pre-Abateme'nt Date: £o j 0(_______

Work Area: I = Inside Work Area Field Technician: ^cyfeemiv/ Contractor: I O = Outside Work Area a)= Ambient, Outside Building Project Manager: Shift Hours: Number of Workers: lo/f^ Initial Final Average Total Total Fibers/cc Sample Sample Pump Flow Flow Flow Time Time Time Volume Limit of NIOSH Number Location and Activity Type Number Rale(l/m) 3ate(l/m Rale(l/m On Off (Minutes (liters) Detection 7400 10- Ufll, j. IS­ HA 21 Tliv F1 Kce 4 Thl Mes h /Ar IS 122 MJ Hl -23— 5- (012- A p i/y IV CiMK>j&7e<Lo _k^ »is- to:^& —x

Signature: . A/ Calibration Method:

Q Chain of Custody H i-< Released by: IV , Accepted by: Date: 10 II Toei I to Signature: Time: ____ r Signature: A- Time: I o Released by: Signature: Date: Time: Accepted by: Signature: _______________ Date: _______________ Time: o I Released by: Date: Accepted by: _______________ Date: o o Signature: Signature: _______________ __Time; _______________Time:

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NYC-WTC_000187374