NYC-WTC_000197624

NYC 9/11 Public Portal Document

w 0. F’SC PSC Analytical Services 4418 Pottsville Pike PSC Work Order # Reading. PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY P^ge ) of 1 fax: (610) 921-9667 or 921-8407 PO# Quote It

JOB ID; Report Name Company Results Malling Address ) Q Ly & Z^TA (/-joor ANALYSIS REQUESTED O' ID to To: City : Slate ZIP ((fQ/o Use attachments if necessary. 0) Telephone Please specify method requirements. Preservatives Key: ai Name A = Ascorbic Acid 0) □ Submit Company C = HCI N2 = NaS2O3

CD Mailing Address H = HNO3 S =H2SO4 Invoice city Slate ZIP I = Ice ;Z = ZnAcetate To: Telephone# Fax# u N = NaOH X = None VI (U 0 Sampled by; Due Date: Credit Card Info (include exp. date) A Sampling Location (Specif State): (Rush TAT requires Lab approval) 1 's O = Other:

L OJ tn Full Data Package REPORTING REQUIREMENTS (Circle all that apply) Reduced Deliverables Package Electronic Data Deliverables .1 Preservatives (See above Key: list all that apply)

u UST NPDES MIPP RCRA Stormwater DEP (PWS» ) Type (P=Plastic, G-Glsss, A-Air)

st: SAMPLE DESCRIPTION Final Air Volume Matrix Type tit p Sampling Info Container Volume (Liter, etc) 2? (ID must match container labels) (L aisiSBl) Date Tiine Number of Containers (0 c cr 1 /flC-03q'l-S"TY~ O C? I r JnhZ. 2 U in 3 0. 4 5 o 6 D. H CO 7 t 8 OJ

I I—i o OJ 9 10 o o □ \ OJ (1) Relinquished by: __ - Date Time (2) Received by. bate Time (3) Relinquished by: Dale Time o o co Dale Time (5) Relinquished by; Dale Time (6) Received at Lab: Date Time o L (4) Received by: cn ID E ) .) T^itvinr BlaloL Ch co co Method of Delivery; UPS FED-E PAS Courier Client US Mail Other

NYC-WTC_000197624