NYC-WTC_000196484

NYC 9/11 Public Portal Document

II PSC 4418 Pottsville Pike Chain of Custody Record Reading, PA 19605 Bottle Type __k Samp/e Container information ■n ID tr phone; (610) 921-8833 fax; (610) 921-9667 I G P IH 1 Ar CD ANALYTICAL SERVICE.S # of Containers □ PO # /oOID PreservecJ? (Y/N) ro Name o Report Company ro Results Mailing Addraaa TI To: Stately ZtP^^/^ ZV^ ■0 Name Telephona # w o Send Dept. 3 3 Invoice Mailing Address ai To: City State ZIP Page _/ of / _ u ft Credit Card Exp. Date PAS Quote# n hl Sampled by: Air Vol. (L Matrix Dale Time SAMPLE DESCRIPTION Type Snnipled Siunplcd W I M/AIC Gomments/Hazards/ Location Details ft 1 3 i ®2 < <0 0 ■25* m a 3 M

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m 6 a 7 to ro 8 CD 9 CD cn lO Q H Special Instructions (including Data Deliverables and Turn Around Time): K I SampieTreiinqinsheT^ Samples Relinquished by. Samples Relinquished to; I Date I Time S o shipper or courier by: 1^^ /____ /) I o Samples received by: j Date I Time Samples Relinquished by: I Samples RelinqujjJJ?d to / Z. Dale Timo-.. o I Laboratory: I o Method of ShipraenVDciivcry: UPS ^ED-B^ PAS Courier (Jlient drop off Other o U co Notes: o Samples Rec'd. on Ice? ( Y Temp. Blank - Sample Temp. CT Samples rec'd intact^^N ) CustoHyseals intact?! Y N ID^ on samples match ) CD cn CO ______ VOC Samples have zero headspace?! Y N Samples properly preserved? I Y N

NYC-WTC_000196484