NYC-WTC_000189689

NYC 9/11 Public Portal Document I .

(0 RSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order # Q. Reading, PA 19605 CHAIN OF CUSTODY phone (610)921-8833 Page - / - ol _ fax: (610) 921-9667 or 921-8407 PO# Quota it

Report Name Cpf) h JOB ID: Company Results Mailing Address O' f C"^ J ANALYSIS REQUESTED CD To: state A/y ZIP Use attachments if necessary CO tn Telephone # 2{ Fax# 6 Please specify method requirements Preservatives Key OJ Name A = Ascorbic Add tn Company N2 = NaS2O3 o Submit C = HCI Mailing Address H = HNO3 S = H2SO4 CD Invoice City stale ZIP Z = ZnAcelate To: fX I = Ice Telephone# Fax# N = NaOH X = None in Credit Card Info (include exp. dale) oi o Sampled by. VU/ Sampling Location (Specify State) A' O = Other Due Date; (Rush TAT requires Lab approval) 5^ L REPORTING REQUIREMENTS (Circle all that apply) W cn Full Data Package Reduced Deliverables Package Electronic Data Deliverables PreservSivss (See above Key, list all that apply) m UST MPDES MIPP RCRA Stormwater DEP (PWS # > Type (P-Plastic, G=Qlass, A=Air) 0 % p SAMPLE DESCRIPTION Final Air VoluiriE Matrix Type Sampling Info Container Volume (Liter, etc) 3) (ID must match container labels) (L Date Tunc Number of Containers m c cc 4> 1 - A>z yZZZZ U'C'> u 2 A-r'C-' 4iLLL V tn 4 3 f^C'O V Q. O’ 4 /Xdc> V e 5 /sc Q 6 0. H CD 7 K tn I 8 to cn I—i S a 9 o OJ 10 o o o 1 (1) Relinquished by .)^ Time [2) Received by Date Time (3) Relinquished by Date Time o in o OJ co (4) Received by IDafe Time ;5) Relinquished by Date Time (6) Received at Lab Date Time o n co 01 _____ Lu Method of Delivery UPS PAS Courier Client US Mail other

NYC-WTC_000189689