Chain of custody record, ATC Associates

NYC 9/11 Public Portal Document

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Chain of Custody Record Samp/e Conta/ner /n formation O’

4418 Pottsville Pike Reading, PA 19605 Bottle Type |_a phone: 1610) 921-8833 fax: (610) 921-9667 I G P IH 1 ANALYTICAL -SERVICES O # of Containers t/Q ro Ipo* Preserved? (Y/N) CrQ Kss: , -j-.-z,.! ' ■■ T^Wiirj-a - I'g^'g.,i,■■.,■, „ □ CD Name -I CoVv*^ CD Report Company A=^c a Twe- TJ Results Malling Address £> K To: City /// “0

Telephon. ' cn w n G Name Telephons t co 03 G Company □ M Send cu n A Invoice Mailing Address K0 I <5V I—' C£ ft o To; Cily State ZIP X|Page j of । »-•• 0 a Credit Card # Exp. Date co PAS Quote# o A tn M Sampled by: Air Vol (L Matrix Dale Time O o Stunpled Sampled fB A o SAMPLE DESCRIPTION - Type / Cominents/Hazards/ Location Details 1 a < < H a I H-

a 0 O M 1 m 03 a w a A M i S<:>LdZ 03 a ' '—— a o V -fe3Ik5jAZZL 05 w £ML O tQ to ro r- w I M CD 05 A 05

to o 0 o co o peclnl Instructions (including Data Deliverables and Turn Around Time):

kJ Samples relinquished to Date I Time Samples Relinquished by: Samples Relinquished to; J Date j Time I VxD shipper or courier by: I So Samples received by; Dale I Time Samples Relinquished by; Samples Relinqui; /Date

o 1 Laboralory: / no icthod of Shipment/Delivery; UPS PAS Courier Client dropoff Other ro o Samples Rac'd, t lce7 (Y N Temp. Blank Sample Temp, Noles ; o u; Samples rec'd intac^ ) Custody seals int^?( Y N iHon samples match I 0^ a.' ■ ■!»■ ' VOC Samples rrav zero haadspacefl Y N ■i.jii, .ii;- , ".’-J—« »■ *■ Samples properly preserved? | Y J J* jam'..I r~ —e bU co CP OO

NYC-WTC_000177760