NYC-WTC_000209718

Zv9eo00000 daNS VLIVNNVO AGHYOM dad ALIO NYC 9/11 Public Portal Document TAYLOR ENVIRONMENTAL GROUP, INC. 130 JERITHO TPKE., FLORAL PARK, NY (1001 Pyatht20 7/2 516-358-2955 Fax 516-358-1780 LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CUENT NAME/ADDRESS CONTACT: we pn ATE TWAE SAMPLE(S} . C DVle7/bowr SEALED A) NO Nw 7 SOPs [prs iA SA vd { SAWPLER NAME |PRiNT) CORRECT ‘ ES NO Lip C Ae Kewseiw _| CONTAINER(S) PROJECT LOCATION: Stey/esand iA-Q | PROJECT # - MATRIX (CIRCLE ONE}: E Sys Chas bevy 7 my M 477-521 7-1928 { i OPE} PANT Soll OFHER SAMPLE INFORMATION: SURFACE MATERIAL AREA (FT?) 5 LABORATORY #] SAMPLE A LOCATION wood] eval] eaicx [omer 1Y Pah AB RESULT Room 91) -Ceifiay Un\ved Lud -0) ) J Lo Brhaust Duct — * i C 0 TEL-) Field Blan y | 1 _ L4 9 FOL? Feld Blak 4. TURNAROUND REQUIRED: COMMENTS / INSTRUCTIONS worm Q sar ov / / Oo HR TAT RELINAY)RHED BY SIGNATURE) OnePGO rye E RECEIVED BY [SIGNATURE} DAIE g7/2R/,, PRINTED NAME IIE 2 FSD / me Hbegn el aTc lab / Shope) TE ¢ 0 9. Kooaw RELINQUISHED BY {SIGNATURE} DATE PRINTED NAME RECEIVED BY LAB (SIGNATURE| DATE PRINTED NAME | TIME TIME NYC-WTC_000209718 WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT