NYC-WTC_000202188

NYC 9/11 Public Portal Document

F5IZ 4418 Pottsville Pike Chain of Custody Record Reading, PA 19605 Bottle Type Sample Container in formation m fD O'

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Credit Carr) # Exp, Date n PAS-Quote#' at Sampled by; J^+iTd n AfrVDr{4s Matrix Date Tunc in SAMPLE DESCRIPTION Type Sampled Sampled n Coinmetils/Hazards/ Locaiioti Details T 1 C 0 / C e’ C - c w 3 /C I? Ci vi- ' ■t

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10 a special Inslruclioiis (including Data Deliverables and Turn Around Time); i-3 1"^ ro Samples relinquished to Date Time Samples Relinquished by: Samples Reiinqiiished Io: I Date I Time SO shipper or courier by; I t-/Vo 2.. i Samples received by. Date j Tinii; ■Samples Relinquished by: Samples Relinquished Io Dale, , Time I Laboralorv: 1^ i Method of Shipmcnt/Delivery: GTS /i s'^TY PaS Courier C'Kent drop ott Other D ’""samples Rec'd. on lce?-( Y/‘^n/a| Temp. Blank ■— Sample-Temp. ~ Notes •. rc -J Samples rec'd intact7©N I Custody seals intact?! Y N ID on samples match COQTON ) VOC Samples have vero.headspacs?! Y hi/n/^ j Samples properly preserved? I Y N (jw) Cn

NYC-WTC_000202188