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NYC-WTC_000200133

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000200133
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NYC 9/11 Public Portal Document TAYLOR ENVIRONMENTAL GROUP, INC. 130 JERICHO TPKE., FLORAL PARK, NY 11001 AT ZlUJI LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT SAMPLER (SISHATURE) Iam Sarus 301uz G SAMPLERNAME (PRINTI etrand SAMPLE(S) SEALED CORRECT CONTAINER/S PROJECT # m 477-1521729881 MATRIX (CIRCLE ONE): SOIL OTHER _ 516-358-2955 Fax 516-358-1780 CLENT NAME/ADDRESS SCA Strepveson PROJECT LOCATION: 345 Chambss SAMPLE INFORMATION: LABORATORY # SAMPLE # 98L-1 9eL-2 -YES) NO YESTNO AREA (FT?) WIPE PAINT SURFACE MĂTERIAL WOOD METAL BRICK OTHER LAB RESULT FB\ LOCATION Im 13ZA Floor en bronce rr132A desk ell Blak Reld Blat 16.0 27.3 <9.0 <9.0 CITY_21MC100_003266594 Fax 212-406-2535 01l 358 1780 RELINQUISHED BY (SIGNATURE) DAIESS|30/6R PRINTEO NAME TIME (830 Petrom RELINQUISTEL BY ISIENATURE) DATE PRINTED NAME TIME NORMAL O STAT • -RECEIYED BY ISIGNATURE DAIE Ни 08/30 RECEIVED BY LAB ISIGNATURET fersinE TIME WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT COMAHETIS/ INSTRECHIONS Sure PRINTED NAME PRINTED NAME NYC-WTC_000200133

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NYC-WTC_000200133Source: NYC Law Department, mirrored locally

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