NYC-WTC_000198899

NYC 9/11 Public Portal Document

Chain of Custody Record Sampfe Container Information 4418 Pottsville Pike Reading, PA 19605 feottle type f—A 5I phone: <610) 921-8833 tax: <810) 921-9667 < R P IH I W ANALYTICAL SERVICES # of Containers m I fpo i Preserved? lY/N) !=> Name Report Companv I-* cn Results GJ To; state /or A '

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Send Invoice MailiiiB Address Oapt, A ? T) 73 O To: City State ———— ZIP XlPage \ of I i?o Credit Card * Exp. Date PAS Quote# z Sampled by: o Air Vol, (L MaJdi Date Time SAMPLE DESCRlPTiOX J«nM- Type Sampled Sampled X Coinmcnls/Hazards/Location Deiails t l|Vic-o|M-g^M~ vr^>c^ ~ § t 2 Arc-olU-gAM-yac^ \^O -< ’ *Te^oUU&^»«VfiC3 4 Mc>OKV\- fij«A ^LaasA- 5 6

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to Samples relinquished to . Date Time Sample! Relinquished by: Samples Relinquished to; J Date I Time I o 3 shipper or courier by: Samples received by: f pZ/Z^A I Date J Time Samples Relinquished by; . Samples Relinquished to I Date I Time •U I Laboratory: I o o 5 Method of Shipment/Delivery: UPS *AS Courier Client dropoff Other s o co Nbtes: M o Samples Rec'd. on Ice? < Y N n/a) Temp. Blank _______ Sample Temp. co (S o w Samples rec’d intact?(Y N I Custody seals intact?) Y N n/a ) ID on samples match COC?( Y N ) VOC Samples have zero headspace.?) Y N n/a) Samples properly preserved? lYN n/a I CT

NYC-WTC_000198899