NYC-WTC_000202203

NYC 9/11 Public Portal Document

F’SC PSC Analytical Services 4418 Pottsville Pike VT Z .<9 PSeWorkOrder# Cj c

Reading, PA 19605 phone: (610) 921-8833 f ? /Y CHAIN OF CUSTODY T Page , / / of/ / 3

fax: (610) 921-9667 or 921-8407 o rd PO# Quote# a Report Nams T7^<rf(‘S JOB ID: 41 Company Results Mailing Address bj

ANALYSIS REQUESTED TJ To; City /y y state /Vy ZIP /OO/ Use attachments if necessary. Whone#2£2j3£>^ Fax# — —- Please specify method requirementsi Preservalives Key: Name A = Ascorbic Add TJ W Submit Company o- C=HCI - N2 = NaS2O3 n Mailing Address H = HNO3 ; Invoice city S =H2SO4 ZIP I = Ice Z = ZnAeetate To: Telephone# Fax# NiNaOH X = None Credit Card Info (include exp. date) Sampled by: Due Date: / y / iASCipt/ ' Sampling Location (Specify State): d /Y'y (Riish TAT reguirss Lab approval) s 0 = Other:

REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables ) 5^

UST NPDES MIPP RCRA Stormwater DEP(PWS# ) SAMPLE DESCRIPTION Final Air Volumt Mafrix Type Sampling Info >

I I I (ID must match container labels) (L Dale yyt^Tme V/ (H 1 2 a 3 .IZ 4 A7Z?-g^ O / T/ 5 iZ I IX) 6 > cn o 7 H H 8 r 9 s 10 o (1) Relinquished Time (2) Received by: Date Time (3) Relinquished by; Dale Time I o o o (4) Received by: A /□Se Time (5) Relinquished by: Date Time (6) Received al Tim -0 co txo -5^ 41 o Method of Delivery: UPS pas Courier Client US Mail Other .7 cn

NYC-WTC_000202203