NYC-WTC_000130056
Report
Results
To:
PO#
Name
Company
PSC Analytical Services
4418 Pottsville Pike
Reading, PA 19605
phone: (610) 921-8833
fax: (610) 921-9667 or 921-8407
RED Burckhardt
Quote #
CHAIN OF CUSTODY
PSC Work Order #
102070550
Page
5 of
JOBID: 125 CeDAR Street.
100/0
ANALYSIS REQUESTED
Use attachments if necessary.
Please specify method requirements.
Submit
Invoice
To:
Sampled by:
Due Date:
City
/ Fax #
Telephone #
Name
Company
Mailing Address
City
AME
State
ZIP
Fax#
Telephone #
Credit Card Info (include exp. date)
Sampling Location (Specify State):
(Rush TAT requires Lab approval)
REPORTING REQUIREMENTS (Circle all that apply)
Reduced Deliverables Package
Electronic Data Deliverables
Preservatives Key:
A = Ascorbic Acid
C = HCI
H = HNO3
1= Ice
N = NaOH
N2 = NaS203
S = H2S04
Z = ZnAcetate
X = None
O = Other:.
Full Data Package
UST
NPDES MIPP RCRA Stormwater
DEP
(PWS #
SAMPLE DESCRIPTION
Final Air Volume
Matrix Typc
(ID must match contamer labcls)
Shs mainy
¡Dale
I@9s - M- W
Wipes 4/202
Sampling Info
Preservatives (Séé above Key:
list all that apply
Type (P=Plastic, G=Glass, A=Air)
Container Volume (Lier, es
Number of Containers
Time
+0 IN-M-W
8S - M -W
henna Edwadl
4) Received by:
9/2/02
Time
((2) Received by:
(5) Relinquished by:
DateR
Date
Time
Time
...
rliont
1S Mail
(3) Relinquished by:
(6) Received al Lab:
Other
Date
Time
9.P/O21020
NYC 9/11 Public Portal Document
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000130056Source: NYC Law Department, mirrored locally
Lab report forwarding mercury background wipe test results from PSC Analytical Services for a building located at 125, collected and analyzed in October 2002.