NYC-WTC_000196737

NYC 9/11 Public Portal Document

pj RSC PSC Analytical Services 4418 Pottsville Pike P^C^o^^^r^ (L Reading, PA 19605 CHAIN OF CUSTODY phone. (610) 921-8833 Page J of j fax: (610) 921-9667 or 921-8407 PO# Quote # Name : JOB ’D: Report Company ft-TS- AgfcfxcJtX t . r' Results Mailing Address U) 10 Q- 3 'riAjkj./V' ■ ANALYSIS REQUESTED to To: C*ly ZX Slate ZIP UsB attachments if necessary m I Telephone i J , 75' Please specify method requirements. Preservatives Key. N Name A = Ascorbic Acid tn o I Submit Company C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 CD Invoice city Stale ZIP r = lce Z = ZnAcetate To: Telephone # Fax# N = NaOH X = None Credit Card Info (include exp. dale)

Sampled by: Due Date: t/ X Sampling Location (Specify State):_____________ (Rush TAT requires Lab approval) 5 O = Olher;

REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P-Plastic, G=Glass, A^Air) % SAMPLE DESCRIPTION Final Air VoliiiiK Matrix Type Sampling Info Container Volume (Liter, etc) I (ID must match container labels) (L or mm) Date Time Number of Containers I 2 TeZZ fo J/C’ et <> o 3 f c ,T c icr(P w Q. 4 -c-4 - 54, 5 0 O 0. 7 A 00 1"^ w 8 9 Q 10 o N

rasnH O (1) Relinquished by Date Time Time (3) Relinquished by; Dale Time o I 7/^<^ o (5) Rehnquis^yby (4, Received by Dale Time Date Time (6) Received at Lab Date Time co o Q. to tn Method of Delivery. UPS D-EX PAS Courier Client US Mail Other CTt

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NYC-WTC_000196737