NYC-WTC_000200109

NYC 9/11 Public Portal Document PAYLOR ENVIRONMENTAL GROUP, INC. 516-358-2955 130 JERICHO TPKE., FLORAL PARK, NY 11001 LEPISZENN OOTOWTZ ALIO Fax 516-358-1780 LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CLIENT NAME/ADDRESS CONTACT: pa R (SIGNATURE) DATE TIME SAMPLE(S} Ces i in AS fil a §~/2 02. SEALED YES / NO vd Gon NAME [PRINT CORRECT ( NYC SCR: HawipD SA J cAadhas oD correct“ C yes) NO PROJECT LOCATION: PROJECT # | MATRIX (CIRCLE ONEf: Gore) PAINT SOIL. OTHER | stuyvessanT 4S . Myq7- (S27 | oa 6 SAMPLE INFORMATION: ‘ SURFACE MATERIAL | AREA (FT?) | LABORATORY #| SAMPLE # LOCATION woop] METAL | BRICK JOTHER LAB RESULT Mai re © Sy oO Aer SpA yo\ @ LW - |O fos TO ef \ x Leta * + A | Pv Sol ec — Uw ~ tf. \ Tio oie ( NRK tour » 4| yA Sol & Lw) ~1& Pa Sele Foot \ v~ on) te Aho ALZAC ro “ fry sol br. : & zor LW ~ \3 Boo CAB ET ( ne ~ hoy - pedis ADA moods winPow iv O-- LW -IS PA SENG sete at | m& 2 = ENTE CY SPT Fj LW ~ [& Fe Flecit ( Ny Brvow) CABAETS TURNAROUND REQUIRED: COMMENTS / INSTRUCTIONS Hay egults % G2 706 ~25 3S norma] = star day / GAks TAT RELINQUISHED BY (SIGNATURE) DATE PRINTED NAME RECEIVED BY "O i 0 PRINTED NAME 7 K120 Z LAG Elid te (BE Cs Qimpe [dl cox RELINOQUISHED By IS a NATURE] DATE yc} PRINTED NAME eS BY LAB [SIGNATURE] DATE PRINTED NAME aw tg 20's c0ra | iouasoel te WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT NYC-WTC_000200110