NYC-WTC_000199110

NYC 9/11 Public Portal Document

PSC 4418 Pottsville Pike Chain of Custody Record Reading, PA 19605 Bottle Type ZjL Sample Container Information Tl (D CT

I G P IH I *—/ 00 phone: (610) 921-8833 fax: (610) 921-9667 ANALYTICAL SERVICES # of Containers CT^ □ ro Ipo# Preserved? (Y/N) C=> =s==:s=s CD Name 03 Cc>hr7 Report Company o Results Mailing Address A-rc $ jfrj c • u T3 > To: I"" Afeco Y»/c TJ tn Name Telephone # n Dept. Send Company □ cu Invoice Address t-*

tr To; City Stale ZIP y|Page 2/-_ of _ f ft

Exp. Date o Credit Card # PAS Quote# 01

Sampled by: Air Vol. (L Matrix Date Time 03 SAMPLE DESCRIPTION usrwin) Type Sampled .Ssunplcd y^Cominents/Hazards/ Location Details m n c l^io beo V 0 2 19.0 ID (A 3 19^0 4 6e>c>~^ 0)

6 o to 7 ru 8 tn 03 03 9 -J o 10 H Special Instructions (including Data Deliverables and Turn Around Time): I—i s Samples relinquished to Xa,) i’ a Date I Time Samples Relinquished by; Samples Relinquished to: I Date I Time o o shipper or courier bv: I " LdizM 1 o Samples received by: . Date ' Time Samples Relinquished by: Samples Relinquished to I o I 1 1 Lnboratory; o co Method of Shipment/Delivcryi DPS Jx PAS Courier Client dropoff Other TO o co Samples Rec'd. on Ice? ( Y Temp. Blank Sample Temp. —- Notes : 00 I—i iC. Samples rec'd intact?i{YjN ) Custody seals intact?! Y N ijT^ ) ID on samples match COC?J(^Tsl ) co ho VOC Samples have zero headspace?! Y N ij^a) Samples properly preserved? ( Y N )

NYC-WTC_000199110