NYC-WTC_000202193

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike PSeWork Order# :z tu n Reading, PA 19605 CHAIN OF CUSTODY 83 Phone:(610) 921-8833 Page 7 of 7 UI fax: (610) 521-9667 or 921-8407 a rd PO# OuoEg# D Report Name Co Arg JOB ID; to

Results Mailing Address ATrc Company ■A

ANALYSIS REQUESTED CU To: state AO/ Use attachmenls if necessary. Telephone ff ^233 Fax # - ^^10 £ Please specify method requirements. Preservatives key: Name A = Ascorbic Acid 13 S? tn Company (J n Submit c = HCI N2 = NaS2O3 Mailing Address H = HNO3 23 Invoice city Slate ZIP S =H2SO4 3 I = ice Z = ZnAcelaffi ID To; Telephone # Credit Card Info (include exp, date) Fax ft It N = NeOH X = None rf-

Sampled fay: Sampling Location (Specify State): 0 = other; n m Due Date: Zt (Rush TAT requires Lab approval) T REPORTING REQUIREMENTS (Circle all that apply) ' tn (D Pull Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key, T list alt that apply) C UST Nr DES MIPP RCRA Stormwater DEP (PWS # ) Type (P-Plastic, GSIass, A-Air) 0 (0 w sE SAMPLE DESCRIPTION Final Air Volunit Matrix Type (ID must match container labels) (L .or niiiTf Date Sampling Info Container Volume (Liter, etc)

Number of Containers 1 2 ^^^ZZ2^ZZ^5= ZS^ZZ 7^122 iz'" /YirjCtr CD a 3 to rtj 4 to 5 V 7 CD tn 6 O H 7 H 8 A 9 I o to

(1) Relinquished Date Time ;2) Received by: Date Time (3) Relinquished by; Date Time 1° co (4) Received by: ' Dale Time ;5) Relinquished by: Date Time (6) Received al Lab: Dale Time TJ

-J nj Cn GJ Method of Delivery: UPS ED-EX PAS Courier Client US Mail Other Gn

NYC-WTC_000202193