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NYC-WTC_000195450

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000195450
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NYC 9/11 Public Portal Document

315 Fullerton Avenue ;VERN fcENT: STI Mewburgh STL CHAIN OF CUSTODY Newburgh, NY 12550 TEL (845) 562-0890 FAX (845) 562-0841 CUSTOMER NAME , ____________ REPORT TYPE TURNAROUND REPORT # (Lab Use Only) ADDRESS J A standardD isra □ NORMAL »-< -.A

^10 /tJ ___________ city, ST^TeZ^ y/ 4 ' NJ REGD NYASP AD clpD □ QUICK SAMPLE TEMP. S'. c ^5/2, SAMPLE REC’D ON ICE Y NAME O^ONTj^ _ phone NO. OTHER □ VERBAL, pH CHECK Y N^ PROJECT LOCATION REVIEWEDBY: __________ _____ Matrix PROJECT NUMBER / PO NO. DW = DRINKING WATER S = SOIL O = OIL NY PUBLIC WATER SUPPLIES WW = WASTE WATER SL = SLUDGE GW = GROUND WATER SOURCE ID

SAMPLING DATE 5 TIME g § ELRPTYPE FEDERAL ID so' MATRIX STL# AM PM O CLIENT I.D.

s I 1 ( OtU’aW

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^MP^ SUBMITTED FOR ANALYSIS WILL BE SUBJECTED TO THE STL TERMS AND CONDITIONS OF SALE (SHORT FORM) UNLESS ALTERNATE TERMS ARE AGREED IN WRITING. (rej^^uiskedby - MA/ COMPANY TIME

EDBX__ C^fcJ^NY TIME

RI lUISH^DH COMPANY UATE ~ TIME

[MENTS AW NYSDOH10142 NJDEP73015 CTDOHS PH-0554 EPA NY049 H-NY049 PA 68-978

NYC-WTC_000195450

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NYC-WTC_000195450Source: NYC Law Department, mirrored locally

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