NYC-WTC_000230466

NYC 9/11 Public Portal Document

Page of ATC ASSOCIATES INC. BATCH NO.

BULK SAMPLE DATA AND CHAIN OF CUSTODY FORM PROJECT INFORMATION ]. Client: NYC - SOE 2. Project Nam AHERA REINSPECTION 3. Project# 14584-OSlS 4. Project MsnageriYiannis Efstathiou

2a. Project A(1drsss:201. Warren Street, New York,NY10282 4a, InvestigaloriYiannis Efstathinu

5. Date: 6, Building Name: P.S.S9M 8. Turnaround Time: 9. Ciomments (Field): □ stat □' Q 72 HRS □ OTHER Analyzed all of them for fiberglass /. Sampling Areas,: 10. Time in 7 Time out: ob i ; 4 ■ Y De HRS □ hours n normal SAMPLE ID MATERIAL LOCATION FLOOR RESULTS H.A.# NUMBER DESCRIPTION NUMBER P.S.89M.5/17/02- .ScYAtiX,.- Fiberglass- /1 Settled. Dust A p-r-Y )

P.S.89M-5/17/02- /^(Ajcli'iDrio^ CT Fiberglass- ( Settled Dust fJac^ P.S.89M-5/17/02- Fiberglass- [ 2^ Settled Dust P.S.89M-5/17/02- Fiberglass- / Settled Dust P.S.89M-5/17/02- Fiberglass- J P.S.89M-5/17/02- Settled Dust .sDI<R f X (F jf RfgA xZ6 Fibergla.ss- 1 Settled Dust A icte, f s rtjF. y/Ctu P.S.89M-5/17/02- Fiberglass- /A Settled Dust P.S.89M-S/17/02- LJ / Fiberglass- Settled Dust dlr^J- P.S.89M-5/17/02- LJ Fiberglass- Settled Dust ■ I. P.S.89M-5/17/02- (-CC27#-L Fiberglass- Settled Dust Llii'GL/ CHAIN OF CUSTODY^ 17. Relinquished By: 18. Date; 19. Time; 20. Received By: 21. Date: 22., Time: 23. Method of Submittal: FIELD ■ ' /

/ / r/zz/^ WALK IN US MAIL FED-X oniER

LAB INFORMATION 24. Name and Signature: 25. Date: 26. Time: 27. Comments (Lab):

24a. Analyzed By: zC ’ S 22 24b. Analyzed By: 24c. QC By:

Filename; P:\VSERS\D?vTAVW?96\WP\rOP<MS'\NY-13.XLS porni NY-13

CONFIDENTIAL, CITY_21MC100_011771134

SUBJECT TO PROTECTIVE ORDER NO. 2, SEPT. 2008

NYC-WTC_000230468