OSHA aromatic hydrocarbon monitoring chain of custody, Oct 2001

NYC 9/11 Public Portal Document

1 jv/ty ---------- Chain of Custody Record Sample Container Information 2 Q EB C 4418 Pottsville Pike Reading, PA 19GO5 Bottle Type 1 phone: (6101 921-8833 (ax: (610) 921-9667 I G P IH I V ANALYTICAL S’LRVICLS if of Containers CTv* po n O wI (5'-174^4-01'39 f^reserved? (Y/N) CT^

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li Q H 01 H Sampled by: Air Vol (L Matrix Djip y Time SAMPLE DESCRIPTION ur mill) Type Sanipky .Sampled (Z3 Coniinents/Hazards/ Location Details o 50 O I 1 ih'h.jtr) X. Q

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A7c7///, A co 6 TITCW/ ~ /o MA / cn H 1/ X O H 7 Afc/z/i - r^ -// C X' tfl ro d?C///Z- XA x /X- -AM X Vt II CD cn !> ~/3- X <n CC' 10 SjKxial InsIrucUniu (including Data Deliverables and Turn Around Time): ASice. ’ Samples relinquisheil Io ’ Time iSainples Relinquished by: Samples Relinquished Io: I bale I Time O shipper or foiirier by: H Sainpits retcivfd by: I Time Samples Relinquished by: 1*^ bJ ; Y _____ Mtitlmd uf Sliipinenl/Deliveiy; UPSQ^ FED-li^ PAS Courier Clienl drop ofl Olliei I : Sumpies Rcc'd. on Samples rec'd inlacb?Y7^ I Temp. Blank ___ Custody seats inlajlT! T hl QVT) _ Sample Temp. ID on samples match COC^Y t'l I Ntilrs : TJ ro o I VOC ’Siiinples IhrVe vein headspaccH Y Samples properly priiseivet^ ( Y N <(y/aj o

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