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NYC-WTC_000189693

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000189693
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NYC 9/11 Public Portal Document

PSC 4418 Pottsville Pike Chain of Custody Record Reading, PA 19605 Bottle Type TT Sampfe Conta/ner /nformation T1 ID tr ro phone: i6101 921-8833 fax; (610) 921-9667 f G P IH I tn ANALYTICAL SERVICES # of Containers □ |po# ro Preserved? (Y/N) - Name 1-* a i Report Company Are Tx-C. Results Mailino Address S 01 lu To:

T tfl Nams Telephone # n 2end C°"^Pany Dept. D 3 Invoice Mailmo Address DI

(C To; City State ZIP ^PageXl'of-t - {+ Credit Card # Exp. Dato n PAS Quote# U I Sampled by: /</ Atr Vol. (L Melrix Dale Time SAMPLE DESCRIPTION or mln) Type Saiiipleil Sampled tfl Commenls/Hazards/ Location Details ID I T 1 C 2 D ID 3 -^2 /o o ne rar- lA

4 <t SlauA. 3 tn 6 □ 7 tfl ro S CD I 9 cn I cn <1 o 10 H Special Instructions (including Data Deliverables and Turn Around Time):

SQ Samples relinquished to ( Time Samples Relinquished by; Samples Relinquished to I Date I Time shipper or courier by: o Samples received by . Date Time Samples Relinquished by. Samples Relinquished Io _ . Date . Tune I o o I I Labelalory: o Method of Shipinent/Delivery. BP'S f Aii Courier Client cirofToTT Allier co tj o Notes • co Samples Rec'd on Ice? ( Y Temp Blank Sample Temp. — tn Samples rec'd intact’0N ) Custody seals intact^f Y N (^)) ID on samples match C0C?(^y^M 1 co ro co VOC Samples have zero headspace’! Y N rr/a^ Samples properly preserved’ | Y N )

NYC-WTC_000189693

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NYC-WTC_000189693Source: NYC Law Department, mirrored locally

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Partial form documenting the chain of custody for samples handled by PSC in Reading, Pennsylvania.

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