NYC-WTC_000197617

NYC 9/11 Public Portal Document

cn OJ RSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order if Q. Reading. PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page L ot i fax; (610) 921-9667 or 921-8407 PO# Quote #

JOB ID; Report Name__________ iTovoci.1 Cohn_____________________________________ company zA s.A rr r-..'■ •_______________________ CD Results Mailing Address EQ5rh Ah-_________________ ANALYSIS REQUESTED CD CD To: City hVY stale ZIP Iqq! Use attachments if necessary. I Ptease specify method requirements. Preservatives Key. OJ Name A = Ascorbic Acid CD - I Company □ Submit C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 CD Invoice City Slate ZIP -1^ 1 = Ice iZ = ZnAcetate To; Telephone # Fax # N = NaOH X = None Credit Card Info (include exp. dale) !

Sampled by: yC ) / Sampling Location (Specify State); O = Other; Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Presen/alivBs (See above Key; list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic. G=Glass, A=Air) Sfc

2 SAMPLE DESCRIPTION Final Air VoIiiiiK Matrix Type Sampling Info Container Volume (Liter, etc)

fc (ID must match container labels) (L or-BUA^ Date Time Number of Containers

1 ATC OS'iM-STY D.of t >H40O A.V Mcti'n UcEly 7

u .1 CD 0. 4 5

6 O CL 7 H CD l"^ cu S to CD (—1 Q 9 S O 10 (—1 CM o O o (1) Relinquished by: -■/ Y Date Time (2) Received by: Date Time ;3) Relinquished by; Date Time I PJ o o OJ (4) Received by: TT' Date Time (5) Relinquished by: Date Time ;6) Received at Lab: Date Time o IP /^s/hvA co Method of Delivery: UPS FED-EX '.PAS Courier Client US Mail Other

NYC-WTC_000197617