NYC-WTC_000199255

NYC 9/11 Public Portal Document

Rsc: PSC Analytical Services 4418 Pottsville Pike PSC Work Order # Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page of fax: (610)921-9667 or 921-8407 PO# Quote It

Report Name " JOB ID: I i I Company Results Mailing Address \ ■ 11 i Y Y' < -fl. ( ' - ■A. f : , ANALYSIS REQUESTED To: City . State >r/ / ZIP ' f ,f.. Use attachments if necessary. Telephone# , , • . 7 7 . A 7 > '■ Fax# f S' < . 7 Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid

Submit Company C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice city State ZIP I = Ice Z = ZnAcetate To: Telephone It Fax# N = NaOH X = None Credit Card Info (include exp. date) a55^=sssassa=aa=s=^=='~T ' Sampled by: .Y > /// Y 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

UST NPDES MIPP RCRA Stormwater DEP (PWS# )

s SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info (ID must match container labels) (E trflmin) Date Time 1 7(- ■ „ 7 - /Ai - i" ) t

2 f - 7 - lT> - /Y L J /' '■ / f I’ I //,, If, /‘/I'

3 , ,-lC - : : YY 7 - U-f - i .1/ ,. Il ,1' „, 4 I

5 6

o 7

I S 8 9

s. 10

(1) Relinquished by: Date Time (2) Received by: Date Time (3) Relinquished by: Date Time

i CT) (4) Received by:

Method of Delivery; UPS Date

FED-EX Time (5) Relinquished by:

PAS Courier Client Date

US Mail Time (6) Received at Lab:

Other Date Time

NYC-WTC_000199255