NYC-WTC_000197650

NYC 9/11 Public Portal Document

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Chain of Custody Record Sample Container information 4418 Pottsville Pike Reading, PA 19605 bottle T*ype phone: (610) 921-8833 fax: (610) 921-9667 ) G P IH ) ANALYTICAL SERVICES ,p^ # of Containers Preserved? (Y/N> C=> Nama Report Company Results Mailina Address JyC-- lO To: state /y/y

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Special Instructions (including Data Deliverables and Turn Around Time):

I I—i Samples relinquished to shipper or courier by: Samples Relinquished by; I o o Samples received by; Date I Time Samples Relinquished by: Samples Relinquished to Date Time 1 o I Laboratory: I | o co Method of Shipment/Delivery: dPSZ^p-EX PAS Courier Client drop oft' Other o Samples Rec‘d,^ft Ice? ( Y Nf^iy Temp, Blank Sample Temp, Notes : <^1

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NYC-WTC_000197650