NYC-WTC_000194794

NYC 9/11 Public Portal Document

a RSC PSC Analytical Services 4418 Pottsville Pike 0. Reading, PA 19605 CHAIN OF CUSTODY phone; (610) 921-8833 Page x of t fax: (610) 921-9667 or 921-8407______________ PO# Quote # i Report Name JOB ID; Company ATc- Auj o cCo-tio T^c- Results Mailing Address /a/Z ANALYSIS REQUESTED CD CD To: City Slate ZIP /O6>/G Use attachments if necessary. cn Telephone# 35'3. 2^3- gS I Please specify method requirements. Preservatives Key: oa Name A = Ascorbic Add CJ) Company________ I Submit C = HCI N2 = Na52O3 o Mailing Address H = HNO3 S = H2SO4 Invoice city U) To: Telephone# State Fax# ZIP J< I = Ice N-NaOH Z = ZnAcetate X = None Credit Card Info (include exp. dale) -J Sampled by: Due Date: Sampling Location (Specify State):_____________ (Rush TAT requires Lab approval) 1 0 = Other:

REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key: * list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic. G^GIass, A=Air) % SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Container Volume (Liter, etc) e (ID must match container labels) (L mint Date Time Number of Containers I ai'r ZAfAiloi- t/ 2 O 3 O U cn 4 D. 5 6 o H CL cu 8 9 s tn I—i

o o 10 o OJ o o (1) Relinquished by: Date Time ||(2) Received by: Data Time (3) Relinquished by: Date Time I o o tn w (4) Received by; Dale Time 1(5) Relinquished by: Date Time (6) Received at Lab: Date Time I—i ex'' J-)?er5-TS- 1'27 93/5” Cn L I—i 0. c Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other •——■———.r

NYC-WTC_000194794