NYC-WTC_000200098

NYC 9/11 Public Portal Document [creme I 130 JERICHO TPKE., FLORAL PARK, NY Ed EC ed Gadd Gad ~ TAYLOR ENVIRONMENTAL GROUP, INC. 11001 ke + Lol a ad _O202 19g [oO - 516-358-2955 Fax 516-358-1780 LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CLIENT NAME/ADDRESS CONTACT: SAMPLER (SIGNATUR DATE TIME SAMPLE(S} eA4 S/oz/oz SEALED Ces) NO C cA Maul Se rot SAMPLER NAME fPRINT} CORRECT AML. Maracer CONTAINER(S} (és) NO PROJECT LOCATION: PROJECT # } MATRIX (CIRCLE ONE}: Stuy we sard HS, BAATT - 18217 /29 £31 | (ii) PAINT SOIL OTHER SAMPLE INFORMATION: SURFACE MATERIAL “4 AREA (FT?) > LABORATORY # SAMPLE # LOCATION WOOD] METAL | BRICK |OTHER LAB RESULT M Lov En Reowaaz7 Ta€Ce ‘ ZLO-O W095 | & S-E stele wd ilows \ as Room #427 {C200 tt by Teacher p+a&SCe | x L2-O ROO #426 Ree 2 Shell HAA by the @laen Gore of ( /X 4A\0-.0 ROC ter ut G2e foo / Roo, # 730 ReAk nooper fhor | x cI ms wid | By dhe Sinn < ef ¢ pm id 2 Recent 934 Cin€s Batkgoes an - S ar x ! Cc W-l4 toon Bx ExuVYrance ( ae) m3 Zoom 4 9 ~ a Room # %%G Stuclenl clese. \ 23 rigs Ww-ts Ky N-E glole entrance = =i Reom #€ 436 (Coor 4 '~ oe W-lé wy Las side Yeachen last \ TURNAROUND REQUIRED: normal) star ay / COMMENTS / INSTRUCTIONS RELINQUISHED BY (SIGNATURE) DATE B/azfa] PRINTED NAME RECEIVED BY,{SIGNATURE} DATE PRINTED NAME , (huni en if - te (520) Ml, Lerawee- Ae we gag Jose ArteingA- | RELINQUISHEL) BY (SIGNATURE) DATE Veo PRINTED NAME RECEIVED BY LAB (SIGNATURE) DATE PRINTED NAME 2 a ime 6/27 hy SS Pea ee TIME w 7 _ GP8ELZTTO OOTONT? ALIO NYC-WTC_000200099 WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT