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NYC-WTC_000232420

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000232420–000232422
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NYC 9/11 Public Portal Document

Taylor environmental group, inc. 130 JERICHO TPKE., FLORAL PARK. NY I 1001 0(0 2_ / I 516-358-2955

Vb [1 Fax 5 I 6-358-1 7 80

LEAD SAMPLING DATA AND CHAIN OF CUSTODY DOCUMENT CLIENT NAME/ADDRESS SCA CONTACT: SAMPLFR (SIGNATURE y , DATE TIME SAMPLE(S) SEALED NO SV'C'V V e S a 4V6-o.^ SAMPLER NAME IPRINT^} / CORRECT CONTAINERfS NO g Aizz 4? 5 7~ PROJECT LOCATION: \ PROJECT # I MATRIX (CIRCLE ONE): CwiPfe PAINT SOIL OTHER

SAMPLE INFORMATION: AREA (FT2) SURFACE MATERIAL LABORATORY # SAMPLE # LOCATION WOOD METAL BRICK OTHER

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G- ,or \ -COO^ \W4C 131 o H S'/Co - t'^vo TURNAROUND REQUIRED: Qj COMMENTS / instructions M I—i NORMAL □ STAT □ BY s a 2- ^a(£> I—i RELINQUISHEDB>tSIGI^URE) date PRINTEC/NAME REC-eiT^p BY (SIGNATUREI "dat? 1 printed name o o I o TIME /4 o REUNQui^H^D^nsiGNA^^ DATE PRINTED NAME RECEIVED BY LAB (SIGNATURE) DATE PRINTED NAME L-j

TIME TIME i WHITE - OFFICE / YELLOW - LAB / PINK - CLIENT

NYC-WTC_000232420

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NYC-WTC_000232420Source: NYC Law Department, mirrored locally

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