Chain of Custody: DEP Cleanup Samples, October 24, 2002

NYC 9/11 Public Portal Document

PSC Analytical Services

Sample Receipt Checklist

•lient Name ATC ASSOCIATES Date and Time Receive 10/11/2002 10:00:00 AM

Work Order Numbe R02100400 Received by TMH

Checklist completed b ( Reviewed by 7)/t- /Q •1/ . O SiyneWre a Iniaals Dale I

Matrix Carrier name FedEx

Shipping container/cooler in good condition? Yes L No U Not Presen I__.~

Custody seals intact on shippping container/cooler? Yes L. No ' _I Not Presen L~

Custody seals intact on sample bottles? Yes L, No U Not Presen n

Chain of custody present? Yes I I No ;]

Chain of custody signed when relinquished and received? Yes 0 No L_H

Chain of custody agrees with sample labels? Yes -A No .~

Samples in proper container/bottle? Yes W1 No

Sample containers intact? Yes lV1 No .L _'

Sufficient sample volume for indicated test? Yes Iii No L

All samples received within holding time? Yes 1 1 No U

o ntaineriTemp Blank temperature in compliance?

Water- VOA vials have zero headspace? No VOA vials submitted J Yes 0 No ❑ Yes r! No

Water - pH acceptable upon receipt? Yes No U

Adjusted? Checked b

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

Client contacted Date contacted: Person contacted

Contacted by: Regarding

Comments:

Corrective Action

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NYC-WTC 000130190