NYC-WTC_000199147

NYC 9/11 Public Portal Document

Page of ATC ASSOCIATES INC. BATCH NO. 2(3'/YZ? 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,NY10007 4a. Investigator:Chacko Mathew

5. Date; 6. Building Name: P.S.234M 8. Turnaround Time: 9. Comments (Field): □ stat □ □ 72 HRS □ OTHER Analyzed all of them for fiberglass 7. Sampling Areas: 10. Time in / Time out: o-U □ 6 HRS 048 HOURS □ NORMAL ^U4)f SAMPLE ID MATERIAL LOCATION FLOOR RESULTS Il H.A.# NUMBER DESCRIPTION NUMBER P.S.234M-5/3^02- \ Fiberglass- tt Settled Dust 1 P.S.234M-5145/02- 9- Fiberglass- c 1~ Settled Dust LlAtOHevA ContxeV*- S<i Ac. te ■ P.S.234M-5/X!i/02- 3 Fiberglass- O2> Settled Dust P.S.234M-5£ES;/0r U'<Cwnd S.A*h M- Fiberglass- Dl^ Settled Dust L Cont-veKt S-aAcxe) V]> P.S.234M-5/at/02- 5 Fiberglass- oS Settled Dust C«» rx •eeVe J) \ P.S.234M-5AS/02- Viursi-S t Fiberglass- oL Settled Dust P.S.234M-5af/02- -7 Fiberglass- Pl Settled Dust \

P.S.234M-5/JC/02- •s Settled Dust Fiberglass- Dis KJb P.S.234M-5,al^/02- \ Fiberglass- ^5 Settled Dust P.S.234M-5/a^/02- V IO Fiberglass- ' * Settled Dust CHAIN OF CUSTODY 17. Relinquished By: 18. Date: 19. Time: 20. Received By: 21. Date: 22. Time: 23. Method of Submitul: FIELD WALK IN US MAIL FED-X OTHER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: 2u. j mi 27. Comments (Lab): 24a. Analyzed By: 24b. Analyzed By: 24c. QC By:

Filename: P:\USERS\DATA1WP96\WP\FORMS\NY-13.XLS FonnNY.B

CITY_21MC100_003031711

NYC-WTC_000199147