NYC-WTC_000187644

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike PSeWork Order# 3 QI T

Reading, PA 19605 CHAIN OF CUSTODY (C QrZ S’S7 ro □ phone; (610)921-8833 Page \ of o fax: (610) 921-9667 or 921-8407__________________ ro PO# Quote # O ■J Report Name JOB ID: O UI Results MaSing AddressfVTc Company ____________ ________ CD .OLc A /k 5 rv»a<>r~^ (OW ANALYSIS REQUESTED u To; ypfk. stale ______ ZIP /doZo Use attachments if necessary. Telephone# £|2, j. vL I?s' ? ■ 27 Please specify method requirements. Preservatives Key: •0 Name A = Ascorbic Acid Ui n Submit Company C = HCI N2 = NaS2O3 I Mailing Address H = HNO3 S = H2SO4 3 Invoice city State ZIP OU I = Ice Z = ZnAcetate To: Telephone # Credit Card Info (include exp. date) Fax # 4.5 N = NaOH X = None I Sampled by; Sampling Location {Specify State): 0 = other; 2 Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) in It Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key: list all that apply) e UST NPDES MIPP RCRA Stormwater DEP (PWS# ) 0 Type (P-PlasSc, G'Giass, A=Air) It It 2 SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L jir WMwj Date Tune Number of Containers

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I—i 9 s o o 122. o (1) Relinquished by: Date Time ;2) Received by. Dale Time (3) Relinquished by: I Dale Time o o T3 (4) Received by: Date Time ;5) Relinquished by: Date Time (G) Received al Lab: Dale lime cn yli J lot <1 o Method of Delivery: UPS FED-EX ?PAS Courier Client US Mai! Other co

NYC-WTC_000187644