OSHA aromatic hydrocarbon monitoring chain of custody, Oct 2001

NYC 9/11 Public Portal Document

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EM Chain of Custody Record c Samp/e Contajner /nformation 03 4418 Pottsville Pike Reading, PA 19605 bottle Type _I 0. phone: 1610) 321-8333 fax; (6101 921-9667 _ in p IN I '—/ ANALYTICAL SERVICES H of Containers

v.'Tc/i)s>c ■“■'°ig-n4q4-o(3q Preserved? (Y/N) (ZZ^

Report Results To: Z±ZZ1Z!JMJe/56]1 2^^ co G W CD Q CO M cn O H Cd CD Dept. O o Send Company Invoice l^^iling Address nj CD § To; City State ZIP // YjPage "of 12 H tfl O Credit Card Exp. Data H VI ! CL < C Sampled by. AlrVdt (b MnlHx Dale Time Pl SAMPLE DESCRIPTION flr min) Typ« Si(niplcd Sampled «»^a7arH«t/ Lnralinn Deia O ?

O a Atc U6Q PiT-iSnc Pl 0) ---- v^-1 G HOG kJ WsM‘74 O m o •H P y\f^'fc iioG '4 Arc UQfe ^Pi -&bU-/PS'67 V ij/iifL '■■'T w n hd D) «—I

C .1 Atc PrfC. t/QG SE — 'A H x ATLtZsG O 0'7 <2121 it u »'7 y CD X (Q-Tr 1/06 S' 4-TC 1/56 -77161 <3Vii3 10 A7<Ji06j<4_n/0_ htiLiflfl W k?) 10 Speefiil Instruclioni (including Dais Delixerablcs and Turn Aruunil Time): CO co o Samples reliniiuished to Y V //A Time Samples Relinquished liy; Samples Rclinquislied Io; Dale I Time H C3 O shipper or courier Samples received byf ^emfusiy yxVL;,,—' J %/ai Dat/' ■ ( 'Time Samples Relinquished hy;

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cn Mciiiuii ofShipmeijVDciivcry; UPiiZTEDT^ PAS Courier Client drop olf Other _ " / O ; o Samples Rec'd. on Ice? [ Y N^flap Temp. Blank Sample Temp. Noles : 5 0 Samples rec'd intact^^N 1 Custodyseals inta.ct?( Y N samples,match COC^ Z ' VOC Samples haw zero headspace?! Y N Samples properly preserver^ [ Y hj^/ -] VO

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