NYC-WTC_000205121

NYC 9/11 Public Portal Document

01/30/02 TOD 13;40 FAX 518 485 1150 NYSDOL-PESH ®01S TVl 09;23 FAX SIS 485 1160 Nl'SDCL-PESfl @002

New York State Department of Labor Public Employee Safety aad Health Bureau

Vehicle Contamination Sampling

SAMPLE #

Vdiicle Locanon or ID;

Vehicle Tj-pe: ^^^^7 Asbestos Before vents turned on After vents turned on Sample Location ___ Dashboard Dashboard ofwipe; ___ Front seat ___ Front seat Floor ___ Floor Back seat Back seat Other: Other:

Metals Sample Location Dashboard ^Dashboard of wipe: Front seat Front seat _ floor -----“ Floor Back seat" Back seat Other: Other:

Other: Sample Location Dashboard ^Dashboard of wipe: Front seat Front scat Floor ^Floor Backseat Back seat Other: Other:

Sample Date:

Sampled Bv;

CITY_21MC100_010222354

NYC-WTC_000205121