NYC-WTC_000196492

NYC 9/11 Public Portal Document

PSC Analytical Services CO 4418 .Pottsville Pike PSC Work Order it

Q. Reading, PA 19605 phone;(610) 921-8833 CHAIN OF CUSTODY ^07,0^00^ ( Page fax: (610) 921-9667 or 921-8407 poT——————————— Narrre Cc’VxYS Report JOB ID; Company A AC -T VLC- Results 'Mailing Address ( ANALYSIS REQUESTED CO To: stale Use attachments if necessary. u Telephone I ;^3 ^2. go 4(A. ZS'3- Please specify method requirements. Preservalivcs Key: tn Name A = Ascorbic Acid nj tn Submit Company 5 C = tICI N2 ’ NaR2O3 □ Mailing Address H = HNO3 S =H2SO4 CD Invoice ci^ stale ZIP I = Ice Z = ZnAcelale To: Telephone # Fa?# N = NaOI I X = None Credit Card Info (include exp. date) tn Sampled by:..-Y-g Sampling Location (Specify Stale): /Vy______ 0 = Olher: tu u 's Due Date: (Rush TAT requires Lab approval) L REPORTING REQUIREMENTS (Circle all that apply) W Preseivalives (See above Key; CD Full Data Package Reduced Deliverables Package Electronic Data Deliverables list at! that apply)

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c tn□ E-i 8 S D y o E-i 10 O w I O □ Dale (1) Relinquished by: Time Timo (3) Relinquished by; Time o o co to □ A 11/ (5) Relinquished by/ / o (4) Received by: Date Time Date Time (6) Received at Lab: Dale Time (JI L cn IQ co E Method of Delivery; UPS FED-EX PAS Courier Client US Mail Other co

NYC-WTC_000196492