NYC-WTC_000199107

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order# T' a Reading. PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY Page f , of I 03

□ ro fax; (610) 921-9667 or 921-8407 □ PO # Quote #

Report JOB ID: , tn Company . □ tj Results Mailing Address 7i~Y>-A<A—■ t O TC ANALYSIS REQUESTED To: State /J y f nC)l/’I Use attachments if necessary. Telephoneff Ij C Fax«^|^. , XToZ? Please specify method requirements. Preservatives Key; T3 tn

i Name A = Ascorbic Acid n Company Submit C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice city

i. state ZIP I = Ice Z = ZnAcetate To; Telephone # Fax# N = NaOH X = None Credit Card info (include exp. date)

Sampled by; Sampling Location (Specify State):_____________ O = Other; Due Dale: (Rush tat requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) I 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-Air)

SAMPLE DESCRIPTION Final Air Volume Sampling Info

I Container Volume (Liter, etc) Matrix Type (ID must match container labels) (L or imi) Date Time Number of Containers tn 1 /jZ-6 3/AT hi- a I 2 tn ro 2 4 I to 5 tn Q tn 6 H K 7 I

I o 8 9

o I o Dale Time (2) Received by: Date Time (3) Relinquished by: Date Time o (1) Relinquished by; T! co o co (4) Received by; Time I5| Relinquished by. Date Time (6) Received at Lab: Time W I—i tC. co NO Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other

NYC-WTC_000199107