NYC-WTC_000199106

NYC 9/11 Public Portal Document

esc PSC Analytical Services 4418 Pottsville Pike Reading, PA 19605 CHAIN OF CUSTODY PSC Work Order # 3 T

phone:(610) 921-8833 fax: (610) 921-9667 or 921-8407 Page of 1 0

c n PO# Quote # c u Report Name JOB ID: Pl Company /y'TY' a Results Mailing Address ANALYSIS REQUESTED at __________________ To: zs y state ' 4IP /^O/^ Use attachments if necessary.

Telephone #2/2 Fax# Please specify method requirements. Preservatives Key: n Name C A = Ascorbic Acid u ’ll r Submit Company C = HC1 N2 = NaS2O3 Mailing Address H HNO3 S = H2SO4 Invoice City

fI state ZIP I = Ice z = ZnAoetate To: Telephone# Fax# N = NaOH X = None Credit Card Info (include exp. date)_________________________________ b- Sampled by:

Due Date:

Full Data Package < ' Sampling Location (Specify State): /NV

(Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply)

Reduced Deliverables Package Electronic Data Deliverables r O = Olher;

Preservatives (See above Key: list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P^PIastic, C^GIass, A-Air)

SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info Container Volume (Liter, etc) LU (ID must match container labels) (L -or iiiiir) Date Number of Containers O'.

2i>

Y'’ 7- /2 c:) u: n 40

5 . 1/ 7 t£ I

o; o 6 o; H 7 8 I—i s o 9 10 o o I n I Relinquished by: Time (2) Received by; Date Time plReiinquistied by. Date Time o o _______ /^7y>c TJ co (4) Received by: ' Time (5) Relinquished by: Date Time 1(6) Received at Lab: o co I—i C tC. Method of Delivery. UPS ED-EX, PAS Courier Client US Mail Other co

NYC-WTC_000199106