NYC-WTC_000202448

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike PSC Work Order #

Reading, PA 19605 CHAIN OF CUSTODY phone: (610) 921-8833 Page i of fax: (610) 921-9667 or 921-8407 po# Quote#

Report Na™________ Atx.^x.t^ faVw______________ _____________ __ JOB ID; Company ATC AfFar/zi-fc. ? ________________ Results Mailing Address । U- jT- I ANALYSIS REQUESTED To: City //gzv y^z A-_______State ^iP/e>o/e_________ ■: Use attachments if necessary. Telephone (X. 2^ Sa l^ax# pjofe Please specify method requirements. Preservatives Key: Name A = Ascorbic Add C = HCI N2 = NaS2O3 Submit Company_________

4 Mailing Address b< H = HN03 S = H2Sa4 Invoice Tty ~ State ZIP I = Ice ;Z = ZnAcetate J To; Telephone ff Fax # N = NaOH X = None Credit Card Info (include exp. date) § Sampled by: A TY-^ Sampling Location (Specify State): A]>f O = Other; Due Date: ™ (Rush TAT requires Lab approval)

REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G^GIass. A=/Nr)

Sampling Info s SAMPLE DESCRIPTION (ID must match container labels) Final Air Volunit (L owam) Matrix Type Date Time Container Volume (Liter, etc)

Number of Containers 1 TeZO . All illj/tL. Lef

2 f^Tc -. 0 g I 4 - u M - /hl I o o dX t 4 .j;/// M- |^ O> O 3 /J & ) 5 4 oil Y- a _ 5

n 6 7 a. 1- 8 N): v 9 S! □ to o w Time (2) Received by. Date Time (3) Relinquished by: Date Time I a (1) Relinquished by:

n (4) Received by: Date Time (5) Relinquished by; Date Time (S) Received at Lab; OJ __ i I w M=D-E^ PAS Courier Client US Mail S' ? ft A it-,r^z\lh/orx /' I IP5R Other

NYC-WTC_000202449