NYC 9/11 Public Portal Document
r-- l r--, r · ·1 ,-----, .----
1 i- ,,. /.i ur___f} l/ 71---, r I .i
r '
\ ~·~ £.. 516-3 58 -2955 i
GRO UP, INC.
TAYL OR ENV IRON MEN TAL Fox 516-~SR-17ea L
I JO JERICHO TPKE, FLORAL PARK,
N'f 11001
~
Y DO CU ME NT '
AN D CH AIN Qf CU ST OD
LE AD SA MP LIN G DA TA ('AT~;. 11M":f<>
~~wtrnn~
11\MPL~ISi YES I NO
CONT/\cr~ 7./d Io A.... SEALED
wrnr NAMEl.~ODRE~I ~ (.,..4. (6. ---~-
\.\o...n,, LORRE CT
I VIMi'LE~ Wll~lirJTI \ CONfAINERf!f
YES I NO
'Sc·\{,) --- --- ~-Q., -::,tr-
S 'rrri v e5.o.'<.\ ~
rRo IECT LO.-AllON;
PROJECT N
MATRIX (CIR(lf ONE): ~ ~~ omrn -- - - - - - - - '
l'<V'-) ':j.':}-1~2!\T} -c;;x:\'&'JI
'Jl'j '3 c:_\--o.'"'\,~ (.., ~\. SURFACE f'v\ATEfilAL LAB RESUtT
f
SAllll PLE INFO RMA T I ON: ··- -·LOC'ITIOl'l,
/\/IV. ffT'I
\i;.'OCJD META!. ORI(~ OTI-IER '
tABOllATORY H S,O.MPLE If
\ 'b'l~'·vof. ~I S-f\C.,, 6 Lb) ..c -j 0 l
\ -<:Q' 3\ "" -~ - ~~...., • v.,_,:\,,.,\- \ '1Z
I I
L1\t '>'"C )/S/ \ ~btb .1\ 2t /. 'I I
-C-€_~'\"- ~~ .. ~ ..... ,., .... _ _ ~
'I l
/J 'A'' ..._ -
3 ~"'S2-s
- - --
\~~-\-- - v--\
".•
l \-"' \ x
r- · ,£ 2. 5
~ f. 2
·-- - ---- ---- ·
l
I
,. ( ~-)l\, "'~~ r~~
--·· y
_L _ - - --
-
-----~
I
I
LI ~ rr :S: 2:. S--
(< ~J2.5
- - -- -
s 1~ ~l~ 1-a\1-
\ \,
\ ---·-· ~
-- - -
y
..
~ !}, ()
I
I
lv \ I
\
'\ •)r - I ---
'!
--r- ____ /0, I --~---·-·
··-
l
!
~ ~s1_3 ~~\ I \ ···- -- I
,_
f
fJ. 0
~
I 'v L
\r- '\\~\\
-
I - __1___ 1
iI
\i
I
~
TURN MOUN D llEOUIRED:
NOR/ .IAL0 Hf.IQ B'!
i I
COMM tNIS I INSTRUCTIONS
;0 )r 9' \6\ ~O(v "'9 S scs.---
f-vv<
I
I
0 ,
;;~
PRINTED NM1E
I,
'i?E'Cf)'.?Y ~:
H
i--l
le<
N
f--'
3:
Ii
0
1;
"""d:7',jl'G~W~I
~llNOUiSHEn !l
-\------~
fHGN." "l•,qr:t
'
···-
OATf 'l{-l{r
TllAE
DATE
S~r.
PRIWfED NAME
~R I NfED N~.ME
· - -- i llECEIVEO BY LAB l-.GtiAlURE)~ D.~IE r·mN ff[l N'-ME
0 "
w 11W
f--'
C)
C)
"co lrnAE
WHIT E· OFFICE l YCl.LO V/ IAO I PINK - Cl.IEN f i!
IC) ~-
C)
co
co
--J
co
(Jl
(Jl
N
NYC-WTC_000231302
OCR can misread numbers and units. Confirm readings against the page image before using them.