Confidential attachment of analytical reports for PCBs

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike Z? PSC Work Order# Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page I_ ot _L fax: (610) 921-9667 or 921-8407 PO# Quote 1t

Report Name JOB ID: 131^3 -0 9 4^4 Company Results Mailing Address ANALYSIS REQUESTED To; State ZIP Use attachments if necessary. w Telephone H 82^0 - ^S3 • %7c L Please specify method requirements. Preservatives Key; G ro Name A = Ascorbic Acid G Submit Company M O C = HCI N2 = NaS2O3 H Mailing Address H = HNO3 S = H2SO4 H Invoice city State ZIP l = lce Z = ZnAcetate O G To: Telephone # Fax# N = NaOH X = None ?3 Credit Card Info (include exp. date) O H M O O Sampled by: tr Sampling Location (Specify State): 2 O = Other: H O Due Date: (Rush TAT requires Lab approval) Hl S < G REPORTING REQUIREMENTS (Circle all that apply) M Hl a Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives'^ (See above O M G s list all that apply) a H M Hl UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G=Glass, A’^r) G > % S ' 2 SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Container Volume (Liter, etc) O

to s (ID must match container labels) Date Time Number of Containers <^3 I

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(1) Relinquished by: Date Time (2) Received by; Date Time 13) Relinquished by: Date Time o I o (4) Received by: Date Time (5) Relinquished by; Date Time ,e|R.ce^^ Dj Time o co co <^D-EX^ PAS Courier to k4othnd nf DpIiVPrV' UPS Client US Mail other_________ ho

NYC-WTC_000175687