NYC-WTC_000196644

NYC 9/11 Public Portal Document

PSC Analytical Services w 4418 Pottsville Pike PSC Work Order # Q. Reading, PA 19605 CHAIN OF CUSTODY I^OZO^Wg) phone; (610) 921-8833 Page j of ( fax: (610) 921-9667 or 921-8407________________ POit Quote #

Report Name X O<vAe,g Avv\ JOB ID: Company (\TC Tvml o Results Mailing Address co LOH & tCv.-.., A- I OTV rkar- ANALYSIS REQUESTED (0 To: Xor* state ZIP fopfo Use attachments if necessary 0) I Telephone#^) 2 O IA . o(^ Please specify method requirements. Preservatives Key W Name A = Ascorbic Acid 0)

o I Submit Company C = HCI N2 = NaS2O3 Mailing Address X H = HNO3 S = H2SO4 co Invoice city Slate ZIP I = Ice Z = ZnAcetale To: Telephone # Fax# A N = NaOH X = None

Sampled by: Credit Card Info (include exp. dale)

A Tim/UN Sampling Location (Specify State): 4 T O = Other: Due Date. ® (Rush TAT requires Lab approval) ^0 REPORTING REQUIREMENTS (Circle all that apply) a:- Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list all that apply) UST NPDES RCRA Stormwater DEP (PWS# ) Type (P=Plastic, Q^^GIass'A^AirJ % 2 SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info Container Volume (LHer, etc)

(ID must match container labels) (L acaam-) Date Time Number of Containers I Arc-o&17- I 7^ - I/O Ct " & 117 {id 0 _ Buk ________ t 2 ATc- I H - t/oc4 /JLo e 0 Pe//ivo^y 71-00 Jll2 U 3 fTTC-O3J-7- \ H - 60 o (A 0. 9 4 IM - I/QCq 5 6 D. 7 o tn H 8 1"^ 9 o So W 10

O 1(1) Relinquished by. Dale Time 11(2) Received by: Date o Time (3) Relinquished by. Date Time o Io a - SflTfoi- (4) Received by: Date Time (5) Relinquished by Date Time (6) Received at Lab: o co u o □ to CE Method of Delivery; UPS ED-EX PAS Courier Client US Mail Other

NYC-WTC_000196644