NYC 9/11 Public Portal Docume nt
i- - r ·· t -·1 r--1 1-·i
,,... .....
\
,. - l
r·
;
·1
'
1
•MLOll ENVllWNM ENTAl GROUP, INC.
IJQJERICHO TFKE .• FLOli'.llLPARK. N'r' I IDOi
21 l!/Y sti -iss-2'155
Fa• S i o -'l SB- \ 780
LEAD SAMP LING DATA AND CHAIN OF CUST ODY DOCUMENT
CLIENT l~AME/ADDRESS CONTAcr: L
c®)1NO
r~OJtCT LOCATION: PROJECT ~
t---~-f_"-1-Y;....IM_S_:q,.,A/:__..__1/_~·:. :cS_ ,_._ _ _-'-_:_,M_~_o/_7_7_-_1_n;_.::,_7£.-'./~~<f'. .: f."-:f,,_,1._, _M'\1RIX 1c.iiKLE ONE/: ~ p,o;wr
_ _ _ . ---~-----.--~-0-IL_ _ 0_1_
H E_R_-_,:--_-_-_-_-_-_-~_-_-_:-_-_-_-~-1
SAf~PLE INFORMA TION:
LABORATORY II - -----
>/IMPLt. ----- ----
W LOCAltON -- ----'
AA&\ !FT't SURI'ACE /\MTElllAL
WOOD MfTN. R'!'O OIJ-IER
-- - - - -
LW-2 L/
,:'oy lw.,,L'/7 J:b ;;;T~"" lURNAP.OUND nEOcJIRED: (OMMfNrS I tNSTRIJCrto,~ s
0
._,
H
l-lD~MAt0 I I
·7&vt?:f//v
RWNQUISHEO EIY j~IGNATUl!£1
PRI~
OllfE 01\Tf PmNT[D NAME
>-<
I
N
f--'
8 . .Ldb>/ ["if a-1V-<JZ
n.11r L.!"<:;'17 .._\,~ w.1r
- li....fE
gLtN OUl!HEO BY (SIGNA!UnEI
~
OA!E PRINH.O NM\£ RtCEWEO av ll\9 {>tC.IWI lllREl PRINT ~D NAME
......
f--' N
(])
-co TIME ' TIME
0 -
0 WtllTE ·OFFICE I YELL OW -1 ,\n I e 1~1v. ,-, '""T
I
0
0
00
00
-....]
..,.
00
..,.
N
NYC-WT C_00023 1192
OCR can misread numbers and units. Confirm readings against the page image before using them.