NYC-WTC_000196594

NYC 9/11 Public Portal Document

(D PSC PSC Analytical Services 4418 Pottsville Pike Q. Reading, PA 19605 CHAIN OF CUSTODY phone (610) 921-8833 Page i ot fax. (610) 921-9667 or 921-8407__________________ PO# Quote #

Report ^3'ng CLhyy JOB ID: Company -A-TC- TA Xv-C-- > CD Results Mailing Address .Crv^xtx^ ANALYSIS REQUESTED CD 0) To: City X/e.tA/ state ziP/Wo Use attachments if necessary I Telephone I j;, 3^-Y . Au -<^3 ■ Please specify method requirements. ' Preservatives Key CJ Name cn A = Ascorbic Acid I Company o Submit T C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 CO Invoice City state ZIP Q .J I = Ice Z = ZnAcelate To:

Sampled by Telephone # Credit Card Info (include exp dale) Fax#

Sampling Location (Specify State):____________ 1 N = NaOH

O = Other; X = None

Due Date'(Rush TAT requires Lab approval) § REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Presenratives (See above Key: list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plasbc, G-Glass, A=Mri % s SAMPLE DESCRIPTION Final Air Volunit MaliIX type Sampling Info Ccntalner Volume (Liter, etc)

(ID must match container labels) (L er mm) Dale Tunc Number of Containers 1 ■ Are.o Ki-f 2 u 3 tn 0. 4 5 6 Q W 7 H tu 8 tn 9 IS o o lU PJ o O o (1) Relinquished by Time (2) Received by: Date Tune (3) Relinquished by: Date time Io tn o tu ' o/e (4) Received by Ttme (5) Relinquished by Dale Time (6) Received at Lab' co o iC. □ NO (E O Method of Delivery: - UPS FED-EX^’ PAS Courier Client US Mail Other CT

NYC-WTC_000196594