NYC-WTC_000209705

NYC 9/11 Public Portal Document WI - WU NEAL CR OU,, 130 JERICHO JPKE., FLORAL PARK, NY 11001 aNd, ZOE 2 a 516-359-2955 NYC-WTC_000209707 Fax $16-358-1780 LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CLIENT NAME/ADDRESS CONTACT: SAMPL std hATUR EY DATE TIME SAMPLE (S} cen , a wy 3 YES)/ NO NIC SoA EEN SAVOS at The aD. SEALED CYES SAMA NAME (PRINT) CORRECT CES NO CONT PROJECT LOCATION: CS7U esant Ae&. | prosect ¥ - 5 — 34S Clabevs ST My [M72 15217 fare Name Reon: Gear sonore SAMPLE INFORMATION: " AREA (FP?) SURFACE MATERIAL LABORATORY #[ SAMPLE # LOCATION wooo| metal | erick [Omer (AB RESULT Redp1 102-4, ploy. Grate ; LwW-05 : La w-o7 RighT Lunifverd —feean / “ IV Ropes (O3Z, South Sie Lu -1O a ~~ may. Left tad Vent foe 1.0 . Poo (O32, Sesh Side Ll -/ f Y / Right LY: vert - pene ( < gj. 0 a 2 Seu St bus -02% Poon 1029, - Deo / a 2 Ff bis -/% Rooms 10379 eit Proto L / 3 Le ly Lun: dent i — Peon / ( . Q Jeet 1039, povll gike (7 5 Liisa “1% 4 ae 2 pte ddle, ae) nia vend reat f vi m —- kotnm (027, Ho Sie _ v Lis-/5 ‘ Lx s Right unt yer} -Poak J U = FRSL~ / Ficld et = - - | Ao GU < FRL The OS / poe ff 5 TURNAROUND REQUIRED. COMMENTS rivsiewCrions Z noma sarQ wv J / 6 He SAS 3 EN ED BY (SIGNATURE) DATE 7/o Lek | | RECEIVED BY (SIGNATURE) DATE PRINTED NAME cep) , C. — C a TIME 270 Lig ( MM OWI TIME % RELINQUISHED BY [SIGNATURE] DATE PRINTED NAME RECEIVED 8Y¥ LAB (SIGNATURE) DATE PRINTED NAME oO S TIME TIME S WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT ol (op) ice}