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NYC-WTC_000199053

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000199053–000199056
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NYC 9/11 Public Portal Document

Page of 4 ATC ASSOCIATES INC. BATCH NO. IIf BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION 1. Client; NYC-BOE ,2. Project Nam AHERA REINSPECTION '3. Project # 14584-0823 4. Project Manager:Yiannis Efstathiou

2a Project Address;292 Greenwich street, New York, NY 10007 4a. investigator.Chacko Mathew

5. Date: 6. Building Name:P.S.234M 8. Turnaround Time: 9. Comments (Field): Q STAT 0 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-3/902

D Fiberglass- \ Settled Dust C It S.wxk<_i.

PS234M-3/902 13-0 \T Fiberglass- Settled Dust PS234M-3/902

4 Fiberglass- i Settled Dust PS234M-3/902 IM Fiberglass- 14 Settled Dust PS234M-3/902 irtxtesc. s I J-x C^too^ IS Fiberglass- 15 Settled Dust PS234M-3/902 C-\a.Si TOC- "O O-TL \ 11 Fiberglass- (L Settled Dust I'exe'V'S yr 7 PS234M-3/902 TJOvvi 0.0 X-

n Fiberglass- (7 Settled Dust PS234M-3/902 C s -> oi . Fiberglass- (v; Settled Dust Yloiy J) PS234M-3/902 CKt-SS Tvi-.-s Q-tt IS Fiberglass- ('t, Settled Dust PS234M-3/902 Fiberglass- ij_ g Settled Dust C I co / 4^ CHAIN OF CUSTODY 17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submittal: FIELD (7 slshZ;. WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26, Time: 27. Comments (Lab); 24a. Analyzed By: 24b. Analyzed By: 24c. QC By:

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

CITY_21MC1OO_OO3O3O963

NYC-WTC_000199054

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NYC-WTC_000199054Source: NYC Law Department, mirrored locally

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