NYC-WTC_000196473

NYC 9/11 Public Portal Document

FSC 4418 Pottsville Pike Chain of Custody Record Reading, PA 19605 Bottle Type Samp/e Container information a ' ID o ANALYTICAL SERVICES L- 1 G P IH I Cd

of Containers CZi^ □ ZL=_=========^^ Preserved? (Y/N) cA Q Cb VA . _______ UI Report U Company Ufe cZcJfc . a Results Mailing Address tj To: 5'®'® xy ■0 (!) Name Telephone # n Dept. X Send □ at Invoice ^*'^'’'^9 Address ? ' 60885 Z- I-' (£ To: City State ZIP age - - 0^ r.

Credit Card t Exp. Data o PAS Quote# 01

Sampled by: Air VoL (L Malri.x Dale Tbnc or win) Sampled Sampled (!) SAMPLE DESCRIPTION Type y^Comments/Hazards/ Location Details IB

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2 t^jr jj/ cy^K'fr.'AAoc- n ID UI 3 HTc-' _____________________ 4 ijot- iry-Hu -fiUvtiK felMMzfc. j/' 5 0) »-• 6 try^ fi^s \‘i7^ 0 o CD 7 kTc- ijiii- ^'ry^ 1^.0 yjpc!,/ ____________ re s fiU.it BLoa^K (D m 9 4 T 0) Q -J 10 H Special Instructions (including Data Deliverables and Turn Around Time):

I o Samples relinquished to shipper or courier bv: Samples Relinquished by: I Samples Relinquished to: Date J Time o I Samples received by: Date j Time Samples Relinquished by; Samples Relinqu^ed to / / i Dale o I Laboratory: rg/^yeK o OJ o Method of shipment/Delivery: UPS ''/TED-EiX^PAS Courier Client drop oL Other -0

Samples Rec'd. on Ice? ( Y N (hlsi Temp. Blank Sample Temp. .Notes : m ai Samples rec'd inta6^^^) Custo^seals intact?) Y ID on samples match COiCiL^ ) rtt LAtJlcC? cl, C7 ,CS.-hM4 VQC Samples have zero headspace?! Y N i^t^) Samples properly preserved? ( Y fc-n/pi

NYC-WTC_000196473