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NYC-WTC_000196538

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000196538
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NYC 9/11 Public Portal Document

Page / of / Tire ASSOCIATES INC. BATCH NO.

BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION I, Client: NYC-BOE 2. Project Nam AHERA REINSPECTION 3. Project# 14584-0823 4. Project Manager: ANDREAS ANDREOU

2a. Project Address:292 Greenwich street, New York, NY 10007 4a. InvestigatoriYiannis Efstathiou

5. Date: 6. Building Name:PS 234M 8. Turnaround Time: 9. Comments (Field): □ STAT □ 24 HRS □ 72 HRS □ OTHER Analyzed all them for fiberglass 7. Sampling Areas: 10. Time in / Time out: □ 6 HRS □ 48 HOURS □ NORMAL SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H-A.# NUMBER DESCRIPTION NUMBER PS234M-2/5/02-

Fiberglass- ( Settled Dust PS234M-2/5/02- Fiberglass- Settled Dust PS234M-2/5/02- Fiberglass- Settled Dust PS234M-2/5/02- Fiberglass-A2/^ Settled Dust PS234M-2/^02-

Fiberglass- Settled Dust rryrrT^c _______ OgTz-CT^ PS234M-2/5/02- Fiberglass- Settled Dust

CHAIN OF CUSTODY 17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal: FIELD .. WALK. IN 7 ' 7 US MAIL / FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: 27. Comments (Lab): 24a. Analyzed By: 4^ 7 24b. Analyzed By: / 24c. QC By: /

Filename: P:\USERS\DATA\WP96\WP\FORMS\NY-13.XLS Form NY-13

CITY_21MC100_006752129

NYC-WTC_000196538

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NYC-WTC_000196538Source: NYC Law Department, mirrored locally

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