OSHA aromatic hydrocarbon monitoring chain of custody, Oct 2001

NYC 9/11 Public Portal Document

Chain of Custody Record I 441S Pottsville Pike Reading, PA 19S05 Samp/e Container kiformation Bottle Type T } phone; <6101 921-8833 fax: <6101 921-9667 _ f_G P JH ) ANALYTICAL .SERVICES /f of Containers iG) r jpo# jqbiD Q (3^ Preserved? (Y/N) t Reportj Compan^' Q Results CD G To: W Oy G M O i Name H o Dept. Send JO o H Invoice Ma>fing Address floi M o o To; City Stata ZIP XlPage ,. v of H O Credit Card U Exp. Dats n < H [pas Quote# ~ a jSampled by: AirVaL (L Matrix Date Time o M JO 3 SAMPLE. DESCRIPTION or mln) Type Sampled Sampled a H Coinments/Hazards/ Location Details M JO 2 H > 3 ' WT _ yuyveiOGT- 7'?' DJf yvlcJicj O 2 e^/W.<=T W>TCtC.Zw.Z 3 to 4 w M 5 T? 32 6

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9 33 10 .ArcJ/jo Special Instrurtions {including Data Deliverables and Turn^ound Time}: -J O H Samples relinquished 1T' \ // // G I Time t Sauiplci Rclinqubhed by: Samplet Rcliniyuished Io: 1^ ro I shipper or courier bv; l [ Time ' Samples received by: iSle Time ISamples Relinquished by; I—i , Samples Relinquished IaZ^ Date 3"-;Time. S I Laboratory: o Method of Shipraent/Dellvery; (JPS PED-E. PAS Couner Ckenl drop oft Other o I Samples Rec’d. on Ice? 1 Temp. Sample Temp. belts: Samples rac'd intJgtTTYY' ) Custody seals in^t?( Y ID on samples match CO^TTlYi VOC Samples have zero headspace?! y Samples properly preserved? f Y 1 on

NYC-WTC_000176329