NYC-WTC_000195448

NYC 9/11 Public Portal Document

g^ivERN TRENT SH Ntwhu'ijh STL CHAIN OF CUSTODY 315 Fullerton Avenue Newburgh, NY 12550 TEL (845) 562-0390 FAX (845) 562-0841 CUSTOMER NAME ^ZZ ______ TZe-xv , c S REPORT TYPE TURNAROUND REPORT # (Lab Use Only) ADDRESS '

CITY. STATE, ZIP standardO israD NJ REG □ NYASP AD B^CLPD □ NORMAL

□ QUICK ZZZ^l^ZZZZI SAMPLE TEMP. 3 .C NAMF^CONTACT y Z PRONE NO- OTH E R __________ ___ SAMPLE REC’D ON ICE Y N □ VERBAL pH CHECK Y^N PROJECT LOCATION ' CHLORINE (RESIDUAL) Y Matrix REVIEWED BY: PROJECT NUMBER / PO NO. DW = DRINKING WATER S = SOIL O = OIL __________ WW = WASTE WATER SL = SLUDGE GW = GROUND WATER NY PUBLIC WATER SUPPLIES SOURCE ID_ NOTE: SAMPLE TEMPERATURE UPON /.../ / //'/-/ J / 1 / k J / / ,4C»T«„TM,-.rc. UMjUlBSS SAMPLING DATE TIME o g CD MATRIX ELRPTYPE FEDERAL ID ---------- ------------- STL# CLIENT I.D. AM PM o KD ANALYSIS REppESTED Q a) 3 I I I I © ©

SAMPLER SUBMITTED FOR ANALYSIS WILI^ SUBJECTED TO THE STL TERMS AND CONDITIONS OF SAI us 'HORT FORJ/} UNLE^yitTER^TE TERMS ARE AGREED IN WRITING RI ED BY COMPANY

/RECEIVED 6 CtjMPANY DATE TIME

RECEIVT^'^ COMPANY DATE y TIME -r^ji^^Z£LY_/Z^c*

COMMENTS

NYSOOH 10142 NJDEP 73016 CTOOHS PH-0554 EPA NY049 M-NYa49 PA BR-37H

NYC-WTC_000195448