NYC-WTC_000199072

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike . PSC Work Order # Q 0

Reading, PA 19605 phone: (610)921-8833 CHAIN OF CUSTODY <<070 Page ^2/^ i of j t

c fax; (610) 921-9667 or 921-8407 r PO# Quote 8 c c Report Name ^CKvS-.- \r\.VA. JOB ’0: c Company 4Tc - Mx’fi (1 (JU-. T we c Results Mailing Address ( oTC >r^ ANALYSIS REQUESTED Q

To: qty /ao/' o Use attachments if necessary. Telephone S 2-2 Fax# (J. ^^3 Please specify method requirements. Preservatives Key: -I Name 0 A = Ascorbic Acid r Company Submit 0 C- HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice City State ZIP o l = lce z = ZnAcetate To: Telephone# Credit Card Info (include exp. date) Fax# K N = NaOH X = None

Sampled by: Sampling Location (Specify State): 0 = Other:

Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data DeliveraWes Preservatives (See above Key: list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plasiic. G^GIass. A=^r)

SAMPLE DESCRIPTION Final Air Volunil Matrix Type i4 Sampling Info Container l/o/ume (Liter, etc)

(ID must match container labels) (L tu jnpil Date Time Number of Containers

I / a 2 /:rc «» Nr if c I 3 4r^ M5 /J.OO C? u h 4 I 5 A Slt-^____________ Ct

o 6 I V __________ 0 0 H 7 K I K to I—i S 9 O 10 o o I (1) Relinquished by; Dale Time (2) Received by; Date Time (3) Relinquished by: Date Time o o -0 co Dale Time (5) Relinquished by: Dale Time (6) Received at Lab: Date Time o (4) Received by: co

Method of Delivery; UPS FED-EX PAS Courier Client US Mail Other k

NYC-WTC_000199072