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NYC-WTC_000232402

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000232402–000232403
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NYC 9/11 Public Portal Document

Taylor environmental group, inc. I 30 JERICHO TPKE.. FLORAL PARK. NY I 100 I 516-353-2955 Fax 516-350-1780

LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CLIENT NAME/ADDRESS CONTACT: SAMPLER ISIGNATURE) DATE TIME SAMPLE(S| YES Ano ________r/2r/c72 SEALED SAMPLRIFnAME (FWNri 5^ CORRECT CONTAINER(S) NO PROJECT LOCATION: PROJECT If MATRIX (CIRCLE ONE): PAINT SOIL OTHER g&f / SAMPLE INFORMATION; AREA (FT’) SURFACE MATERIAL lAB RESULT LABORATORY # SAMPLE # LOCATION WOOD METAL BRICK OTHER

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TURNAROUND REQUIRED: COMMENTS / INSTRUCTIONS to NORMAL Q STAT Q O o R E UNQ^W^^^(SIG^pj R E) date PRINTED NAME RECEIVED BY (SIGNATURE) DATE PRINTED NAME o I o TIME /Q'.h(9 TIME o RELINOfjTsHED BY (SIGNATURE) DATE RECEIVED BY LAB (SIGNATURE) PRINTED NAME PRINTED NAME CO cn TIME iC. TIME O CO WHITE - OFFICE / YELLOW - lAB / PINK - CLIENT

NYC-WTC_000232403

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NYC-WTC_000232403Source: NYC Law Department, mirrored locally

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