Analytical services header, 75 Park Place project, Feb 2002

NYC 9/11 Public Portal Document • Friday, March 01, 2002 10:34 AM EHI, Inc. 973-729-5649 p.20 F.b.25 02 01:18p PSC Rnalytical Services 6109219667 p.3

PSC Analytical Services

Sample Receipt Checklist

Client Name ENVIRONMENTAL HEALTH I Date and Time Receive 2/21/2002 4:30:oo AM Work Order Numbe R02020734 Received by PRS

Checklist completed b / Reviewed by NR~als ~— Date Matrix Carrier name FedEx

Shipping container/cooler in good condition? Yes iz No U Not Presen Li Custody seats intact on shippping eontaher/tooter? Yes F No El Not Presen Custody seals intact on sample bottles? Yes .I No U Not Presen Chain of custody present? Yes (,d No El Chain of custody signed when relinquished and received? Yes l No Chain of custody agrees with sample labels? Yes iL Not] Samples in proper container/bottle? Yes 2 No n Sample Containers Intact? Yes ® No Sufficient sample volume for Indicated test? Yes lj[ No 0 All samptoe received within holding time? Yes 0 No n Container/Temp Blank temperature In compliance? Yes 2 No Water - VOA vials have zero headspace? No VOA vials submitted ISL Yes n No Water - pH acceptable upon receipt? Yes J No

' Adjusted? Checked b

Any No and/or NA (not applicable) response must be detailed in the comments section b

Client contacted _ Date contacted: Person oontacled

Contacted by: Regarding —

Comments:

Corrective Action:

1

NYC-WTC 000095894