NYC-WTC_000200160

NYC 9/11 Public Portal Document

T^nARfeNViR6NAEi4irAl^ta6^^-9^lL^^ PAGE 3__ OF. TECHNI CLIENT \ " SITE ADDRESS DATE SUBMITTED

1.A a4^ oA- ue^4A-H- DATE SAMPLED 7 WORK A^A * 7 ’ / DATE LOGGED

■a-ZO-O' ROTOMETER PROJECT NO PROJECT MJi^OeR DATE APPROVED / SIGNATURE

-14-^ H 4^?- /^Z/y- SAMPLE & LABORATORY SAMPLE LOCATION, AREA & FLOW TIME TIME DURATION FLOW MINUTES (AVER­ LITERS FIELDS FIBERS F/MM2 F/CC PUMP# NO. HEIGHT AND/OR EMPLOYEE ON/OFF ON OFF AGE) IWA X OWA □ 105 li/0 ^■5 IWA X OWA a \dS no (HO IWA X OWA □ (^0 I HP IWA /i OWA a lo^ %)£//? IS.3^ 1X0 (^(? c

S'? owA'^ V, w. <3

7Z> •** /^•/lo'^’tYtTz^ij^A -r75oo’i2L_ o l^.hi (» « iHi? -o -st si I** X Zg^^l lif-M Iio 'l.f AF-Z? mo . IWA yCLtiS^ c\-cT^ (J i/7? rF<>v -c^

.......... OWA □ I no 1300 IWA / pzw OWA g IWA , iS-tKi/CtM. i^-T iw 0/ ;o2i(v I?I8,

IWA /j /Lo'^ to A-a — I/O ms' iQ 113^ AS - I’ OWAD IWA f't-Crtlu A< r{.« no l%Q no iii» iwA / FtXfp o I—I H As- L^l °WA^° v/^ 1 ^.JV- iq,(w 110 (300 RELINQUISREa TCfTEa DROP BOX (SIONATURE) DATE TIME RECeiveO FAOMTEQ DROP (SIGNATURE) I CIRCLE I N) so TIME />A PCM HEMJ RELINQUISHED BY: (SIGNATURE) A DATE TIME RECEIVED BY; (SIGNATURE) DATE BORO PRE DURING POST

-F o ("^ 7,WZ QSHA ................................ ... SHw 1 -V2O 'y lOTl

f lUER MANUFACTURER ll ' ^HIT^<Cftice Copy YftteWMrfrtrCOpy PINK; Samples OR/TOOfT-Stte-Copy ----- (ahr

NYC-WTC_000200160