NYC-WTC_000197636

NYC 9/11 Public Portal Document I .

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in Chain of Custody Record Samp/e Container Information CL S3 mu 4418 Pottsville Pike Reading, PA 19605 ““ Bottle Type phone; (6101 921-8833 fax; (610) 921-9667 ( G P IH I ANALYTICAL SERVICES # of Containers CZ^ Ipo# Job ID Preserved? {Y/Nl CZ^ Name ^c3oVwve.>^ (jeV>r\ Report Company fcoacCU 4^ VVO Results Mailing Address Tk

CD To; CD m Wk) T-< Telephone - g j cG cu CD Name Telephone # O Dept. CD Send Company z Invoice Address To: City State ZIP W X|Page \ of _ | W Credit Card Exp. Date u PAS Quote# Sampled by: ty Air Vol. (L Matrix Dale Time L .Sampled SAMPLE DESCRIPTION Type Sampled I . ID Comments/Hazards/ Location Details CD 1 j 4rc^ ^6 Id u 'W 2

+> 3 ££ If / viT^k-i 3) 4 A-Yc-o|c9-jT/- •‘L V Id c 5 X 6 (J CD 7 X 8

9 O 0. 10 H □ m Special Instructions (including Duta Deliverables and Turn Around Time): to ■4-

s□ O PJ Samples Relinquished by: Samples Relinquished to; Date , Time I—i o □ Samples received by; Date Time o Samples Relinquished by: Samples Relinquished to J Date I Time I 1 Laboratory: o t\l o co Method of Shipment/Delivory: UPS PAS Courier Client drop off Other o C Id Notes: iC. cn n Samples Rec'd. on Ice? ( Y N'TTa) Temp. Blank Sample Temp. iC. Samples rec'd intact?(Y N ) Custody seals intact?! Y N n/a ) ID on samples match C0C?( Y N ) VOC Samples have zero headspace?! Y N n/a I Samples orooerlv ureserved? (Y N nZa I

NYC-WTC_000197636