NYC-WTC_000199099

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike PSC Worl^rder it n u 1

Reading, PA 19605 CHAIN OF CUSTODY rt u phone: (610) 921-8833 Page of -I C fax: (610) 921-9667 or 921-8407 C PO# Quote # rt

Report Name S Ck wveys, Co A JOB ID: 0^7-? Company -(\L\ Q ^SCg-cCoJZ, u Results Mailing Address \o U ANALYSIS REQUESTED -0

To; City state ZIP /ao/c Use attachments if necessary.

Telephone1^ . 3:^3 . 83<56 Please specify method requirements. Preservatives Key. Name A = Ascorbic Add

Submit Company Mailing Address 3®^ C = HCI H = HNO3 N2 = NaS2O3 S = H2SO4 Invoice city To; Telephone# Slate Fax# ZIP 4 I = Ice N = NaOH 2 = ZnAcetate X = None Credit Card Info (include exp. date)

Sampled by: Sampling Location (Specify State): O = Other; Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; ' list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G-Glass, A=Airj

SAMPLE DESCRIPTION Final Air Volume Matrix Type I Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L-«»wai4 Date Time Number of Containers 1 ZZ5Z CT

c 2 /^Q X O 6> I o t£ 3 __/X6_ rc 4 1^0 ^cTcj I 5 < ■ tr o; Q 6 O'. H 7

to 8 I—i S 9 O 10 o o I (1) Relinquished by: Date Time (2) Received by: Dale Time 1(3) Relinquished by: Date Time o o tJ co Date Time (5> Relinquished by: Date Time (6) Received at Lab; o (4) Received by: Date Time co o; I—i LLTyLL co co Method of Delivery: UPS D-E PAS Courier Client US Mail Other

NYC-WTC_000199099