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NYC-WTC_000209690

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000209690–000209692
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NYC 9/11 Public Portal Document PAYLOR ENVIRONMENTAL GROUP, INC. 130 JERICHO TPKE., FLORAL PARK, NY 11001 LUSS/ 516-358-2955 Fax 616-358-1790 LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CLIENT NAME/ADDRESS SCA CONTACT: Kea mwe'al Se a i PROJECT LOCATION: Stuy vessnd MS PROJECT &# M477 - 15217) 296 $47 SAMPLER |SJGNATURE DATE WAE SAMPLE|S} - 7/2 4for. SEALED NO SAMPLER NAME (PRINT| CORRECT C, Laracee’ CONTAINERS} CYES # NO MATRIX (CIRCLE ONE}: (Gre) PAINT SOIL. OTHER NYC-WTC_000209692 WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT SAMPLE INFORMATION: AREA (eT) |__SURFACE MATERIAL LAB RESULT Z LABORATORY # SAMPLE # LOCATION WOOD | METAL | BRICK JOTHER pg. / 4h Reouw #1080 Rathnaory Z Rus -1% Lavon A the chests ( aa JO Roun. ef 1D A _ SY OTA tenaoes Z cB UAT Le Hoon Cn t“e EA eS pee e ( x . LO Room wu ose SEp Bla x Z Rw-14 Poon by Entaanee | x I, 0 Cops ‘clone & dover IOFF Rw-2O (oar ( xX Z t Z Qw CoO 10 pe (Ou & Boece at MB Z -& 2) : {aor | “a £2 2 W Couns tfon Ea reader ot 1002 | Z ae a < FE . -2 a 4 Z S Pw -23 [3 Z G D by 2 Bw-ey F fe “ ’ £40 S TURNAROUND REQUIRED: COMMENTS / INSTRUCTIONS > = ; Normal Q) m4 BY / phi vA OQ . RELINQUISHED BY {SIGNATURE} DAIE Zep) PRINTED NAME RECEIVED BY (SIGNATURE| DATE 7 29 | PRINTED NAME Ww —_— . BE aa 0 ais [TIME @ fae WL, a tantne-, &, Bivudi ua ME gf po| A. Oroudtena 2 RELINQUISHED BY {SIGNATURE} DATE PRINTED NAME RECEIVED BY LAB (SIGNATURE] OATE PRINTED NAME oO S HME TIME os) B& oO ~

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NYC-WTC_000209692Source: NYC Law Department, mirrored locally

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