NYC-WTC_000188351

NYC 9/11 Public Portal Document

0 Rsc: PSC Analytical Services 4418 Pottsville Pike L Reading, PA 19605 CHAIN OF CUSTODY Page L ot phone: (610) 921-8833 fax; (610) 921-9667 or 921-8407 PO# __ Quote#

Report Name •ZT? JOB ID: Company ~~ Results Mailing Address ANALYSIS REQUESTED X X X To: City /VV state ZIP /^O/P Use attachments if necessary. I Fax#----------- 2- Telephone# Please specify method requirements. Preservatives Key: N Name A = Ascorbic Add tn I o Submit Company C = HC1 N2 = NaS2O3 Mailing Address H = HN03 S -H2SO4 •-4 co Invoice city State ZIP .-J 1 = Ice Z = ZnAcetate To: Telephone# Fax# N«NaOH X = None

Sampled by; Credit Card hifo findude exp. dale) Sampling Location (Specify State): 7^ .1 O = other. Due Date: _________________ ____ ____________ (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) I vs- Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list an that af^ty) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Tj/pe (P=Plastic, G=Glass, A^Air)

5 SAMPLE DESCRIPTION Final Air Volume Mairi* Type Sampling info Container Volume (Liter, etc) UJ (ID must match container labels) (L *1 iiTin) Date Time Number of Containers 1 I 2

u 3 tn 0. 4 o 5 H 5 7 to tn S T. 8 2o »□ 9 o 10 I w § ° (1) Relinquished by: Time [1(2) Received by: Dale Time (3) Relinquished by: Date Time o r- -1 w Time 11(5) Relinquished by: Dale Time (4) Received by:

° § ^^'^ther Method of Delivery; UPS PAS Courier Client US Mail

NYC-WTC_000188351