NYC-WTC
000
130057
PSC
PSC Analytical Services
4418 Pottsville Pike
Reading, PA 19605
phone: (610) 921-8833
fax: (610) 921-9667 or 921-8407
Quote #
CHAIN OF CUSTODY
PSC Work Order #
ROLOTO55O
Page
PO#
Report
Name FRED BurcKhardT
Results
Company ATC AsSOciAleS
Mailing Address 104 E. 25'h
To:
City
2
State
Telephone #
Name
Submit
Company
Invoice
Mailing Address
City
SAME
State
To:
Telephone #
Credit Card Info (include exp. date)
N. Fax o
ZIP
10010
JOBID: 125 CeUAR St.
ANALYSIS REQUESTED
Use attachments if necessary
Please specify method requirements.
ZIP
Fax #
Preservatives Key:
A = Ascorbic Acid
C = HCI
H = HNO3
1 =Ice
N = NaOH
N2 = NaS203
S = H2S04
Z = ZnAcetate
x= None.
Sampled by:
Due Date:
Sampling Location (Specify State):
(Rush TAT requires Lab approval)
REPORTING REQUIREMENTS (Circle all that apply)
Full Data Package
Reduced Deliverables Package
Electronic Data Deliverables
UST
NPDES MIPP RCRAStormwater
DEP (PWS#
SAMPLE DESCRIPTION Final Air Volume
(ID must match contamer labcls)
#Mhim
Matrix Type
R8N - M. W
WipE
Sampling Info
Date
7/2/02
Time
O = Other:
Preservaines (Seé above Key:
list all that apply)
...
Type (P=Plastic, G=Glass, A=Air)
Container Volume (Liter, etc)
Number of Containers
•75-M-W
•7N-M-W
'any Edlwads
(4) Received by:
T(2) Received by:
(5) Relinquished by:
Date
Date
Time
Time
|(3) Relinquished by:
(6) Received at Lab:
Date
Time
91902100
NYC 9/11 Public Portal Document
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000130057Source: 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.