NYC-WTC_000199100

NYC 9/11 Public Portal Document

PSC Analytical Services . z 01 (£ 4418 Pottsville Pike PSC Work Order#

Reading, PA 19605 CHAIN OF CUSTODY rj

phone; (610) 921-8833 Page of □ ro ___________fax: (610)921-9667 or 921-8407_____________ a PO # Quote * CD

Report Name ___ JOB ID; Ml Q -U Company ATM Arf < Q C? CctC. Tvc, ____________ m 01 Results Mailing Address f OTV< ANALYSIS REQUESTED To: City /t/^ zoo/o Use attachments if necessary. Telephone J) S? 9.70 Please specify method requirements. Preservatives Key; T tn Name A = Ascorbic Acid n Company C = HCI N2 = NaS2O3 Submit Mailing Address H = HN03 S =H2SO4 Invoice City State ZIP 0 I = Ice Z = ZnAcelale <5 To: Telephone # Fair# MS N = NaOH X = None Credit Card Info (include exp. date) re/- Pt Sampling Location (Specify Stale): ~ O = Other: Sampled by: I Due Date; C/ (Rush TAT requires Lab approval) 13 REPORTING REQUIREMENTS (Circle all that apply) Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key: ' Full Data Package list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G=Glass, A=Air) at 2 SAMPLE DESCRIPTION Final Air Vnlum< Matrix Type Sampling Info Container Volume (Liter, etc) u; f- (ID must match container labels) (L Of wm) Date Time Number of Containers o; 12 2^ o __ MeUvi, gtA-E c 2« ATc - oi'/4 - ~ £1 o _ i'fTffltet Cenf<»i. Cj ex __ ^<9 0 11 ____ u I 51* $ ZauK L _____________ a o a 6 H K I to 8 I—i s o 9 o in o I (2) Received by: Date Time (3) Relinquished by; o (1) Relinquished by: Date Time Date Time o co o Date Time (5) Relinquished by: Date Time (6) Received at Labi' _ Date Time (4) Received by: co ____________ r co ho Method of Delivery: UPS PAS Courier Client US Mail Other

NYC-WTC_000199100