NYC-WTC_000208714

NYC 9/11 Public Portal Document

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BATCH NO. . „ i N C

PROJECT INFORMATION SULK SAMPLE D.ATA AND CHAIN OF CUSTODY FORM 1. Client: 2. Project Name; 3. ' No,

5. Date; 6. Building Name; ws<Hrx»w 3. Turnaround lims: 41. Investigator' S. Comments (Field) □ STAT □ 24 HRS □ 72 HRS □ other 4zV’4Ay2.f H 7. Sampling Areas: □ 6 HRS □ 48 HRS □ NORMAL- □— 575b<KA<> If.-/ pi.!^ BULK SAMPLE LOCATION 10. 11 12. 13. 14. Sample'Location 15. 16. Material Maierial Asbestos Homogenous Bulk Sample Thermal Total Quantity Content Area Mo. ID No. System Floor Sample Coordinates (LF, SF, PCS) (Type & %) i c^*v O '6. L-IL £-Zoi.t >«’/Lo

6 - 7 L-- Zt >/ fl

1/ It // IL ^1'7 H d £i9' II A li /I 4- ft II d Z'L d 6'73.' II i & fl d d-i r IL d ft It II II 1'1 II ’ll /I CHAIN OF CUSTOOY 18, Date: 19. Time: 20. Received By: 21, Date: 22. Time: 23.Method oi Suomittai: 17. Relinquished 3'/: ----- 7—---------- iZlLL— ■ IN ' / US MAIL Il // -------------- ------------ FED L vdi OTHER

LAS INFORMATION 25. Date: 2S. Time: 2/. Comments (Lab) 24. Name and Signature

24a. .Analyzed By,' JILL A 24b. Analyzea By:

24c. QC By: JiAlA2=^£t2k Idld 3^ “ 0 NY-'l.a .:3/99)

CITY_21MC100_007210874

NYC-WTC_000208715