Chain of custody record for analytical services, Oct 2001

NYC 9/11 Public Portal Document

Kftll t_i . Chain of Custody Record Sampfe Container Information Ill <3 PMBHMHBaMaaBi

ANALYTICAL SERVICES 4418 Pottsville Pike Reading, PA 19605 phone: (610» 921-8833 fax: (6101 921-9667 Bottle Type ( G P IH 1 # of Containers 1111111 r □ 03

O IPO* Preserved? (Y/N) L-^ H ro Name □ Report Compeny Results Mailing Address U3 <<; '3. hl To;

Telephone ■a w tfl G Name Telephone # n tn G Send Company__ Dept. □3 M 3 O

hJ’/ZlJgTZ H Al Invoice M®'lir>9 Address t-J

H (£ City State ZIP O To: «♦ W' m Exp. Date 0 ?n Credit Card # PAS Quote# Al o H M Sampled by: Al»*ottfc Malrii Dale Time O O Type Sampled Sampled cn SAMPLE DESCRIPTION H Hl < O S m ifSSi Comments/Hazards/Ixic^^ioq flails It

M Hl a A o ?n M s 2 ------------ A o IB a M H Hl A 1*1 ?a S o ' > d- J 2 ! tn t-* to 6 □ 7 (C w w M H3 « (D H 0) 9 m to -J o la o co Special Instructions (including Data Deliverables and Turn Around Time): O

H Samples relinquished to Date . Time Samples Relinquished by: Samples Relinquished to: I Date I Time K I to shipper or courier bv: I J I I o Samples received by: ______________________________ — Method of Shipmcnt/Delivery; Ur S \^D-E. I Date

PAS Courier I Time /f Samples Relinquished by: WB Other ■n o I Samples Rec'd. on Ice? ( Y Temp. Blank^______ Sample Temp. _ Nut«; o w o Samples rec'd intact(^5* * Custody seals intact?! Y Fd on samples match C0C??^N ) co VQC Samples have zero headspace?! Y Ng5^) Samples properly preserved? ( Y N (?7r> co co o cn

NYC-WTC_000175778