OSHA aromatic hydrocarbon monitoring chain of custody, Oct 2001

NYC 9/11 Public Portal Document

TaZn B Chain of Custody scord Sample Container In fori lion 441B Pottsvills Pike Peading. PA 19605 2 Bottle Type 0 phone: (610) 921-8833 fax; 1610) 921-9667 ■ I G P IH ) < analytical SERVICES # of Containers re !PO H m Preserved? ,{Y/N) iNama a Report! Connpany^^ a Results ro CP

J To: OD co § A/FW vaiL Telephone N 'i leoi e "5

Q M O Name H Telephone # "0 H O Send! Ccnipany Dept. n X) Invoice] Mailing Address 3 X 3 o HI H To:i ■City Slate 2JP XjPage O Q Credit Card Exp. Date (pas Quote# ' —• V C£ ft o s < PI XI I—I Isamp^d by: AlPVola (L Matrix Dale Time 0 ID o SAMPLE DESCRIPTION or min) Typ« Sampled Sampled o w Comments/Hazards/ Location Details XI □ H I tn M nt X T 2: 2 --52Y7 < o 3 0 tn •4 w w 5 w X 6 H cn 7 Q AT (0 8 ru CO s CD tn in tn -J Speciiil InidULlioiis (including Data Delircrablei and Turn Around Time): fZ Samples relinquished (o Samples Kelinquished by: Samples Relinquished to: I Dale I Time

IS Jb , i shipper or courier by: ■ Sainples received by:

Method (if Shipinent/OcHvciy; . ■_■■ (. 1 I 'FEEi-B^^ PAS Courier iSanipies Relinquished by: _____ Client drop otL Other I Samples Relinquished to LaborainrY: Date Time

Samples Rec'd. m Ice? ( Y (f^yn/aj Temp. Blank Sample Temp. Noles: “0 Samples rec'd intact/lY^ 1 Custody seals irita.ct?( Y N ID on sarnples.match C0C?($7t )

o VOC Samples'have zero headspace?! y N/n7^ ) Samples properly preservec^ ( V N X/aJ

r NYC-WTC_000176322