Chain of custody record for analytical services, Dec 2001

NYC 9/11 Public Portal Document

G Chain of Custody Record Samp/e Container information (D O 4418 Pottsville Pike Reading, PA 19605 Bottle Type fas. "ST -rx-CT-n*- i«c.sjn: -ms .a. j*S-daf

ANALYTICAL SERVICES x phone: (610) 921-8833 fax: (610) 921-9667 _ 1 G P im '4 to # of Containers □ IPO # Preserved? (Y/N) “\ob\AA-ez> GzWa • ______________ a Report company Ajg O JVo (J Results Mailing Address M at To: w "0 G w ro Name Telephone t n G M O H Send Company Dept. 03 □ H O Invoice Mailing Address

To: City State ZIP /1^ Page | of ( CD C£ c+ G 73 O Credit Card 9 Exp, Date H PAS Quote# 0 hl M O O Sampled by; Air Vol. (L Matrix Date Time H O H S SAMPLE DESCRIPTION or min) Type Sum pled Snmpled CD y' Comments/Hazards/ Location Details 3a CourtaaAhcr' ID 1 o M 1 - Cf>t /^/o6 &f7 C 73 S 2 iJLo 6- Jtl W ^£>0 .fOuXV TtAlrtid-x. □ -k a H M HI T 73 > 3 4-rc.-(jLo6 lit S ' 4 O 5 to m 6 co □ M 7 CD 73 re H S CD 01 9 0) O O -J 10 CO o Special Instructions (including Data Deliverables and Turn Around Time): H K I Date I Time Samples Relinquished by: Samples Relinquished to: I Date I Time to I I o Samples received by; Date , Time Samples Relinquished by: Samples Relinquished t^ I Laboratory: D^ yub>-f ^-Zr/TC/ Time.— IZ'^gg^ o Method orShiptnenVDelivery; UPS ^FED-E PAS Courier Client drop off Other I 73 o Samples Rec'd. op Ice? ( Y hPerT^^ o Temp. Blank Sample Temp, iNotcj : co ru Samples rec'd intact ) Custody seals intact?) Y ) ID on samples match COQiYvN ) VOC Samples have zero headspace?! Y Samples properly preserved? ( Y fVnZa))

iC.

NYC-WTC_000177866