NYC-WTC_000202591

NYC 9/11 Public Portal Document

[ SOU cn

cn Chain of Custody Record Sampfe Container /nformation S) 4418 Potts villa Pike Reading, PA 19605 [“ Bottle Type Ld phone: (610) 921-8833 fax: (610) 921-9667 f G P IH ) CD ANALYTICAL SERVICES <r # of Containers □_ Preserved? (Y/N) CZ^

Report Compare v* Results — -——— y9-rc Ta: Mailing Adaresh' /gr £ A/V state

Fax f ------------ Name Tefephone # co Send Cumpanv _ Depl, ___ s I—J Invoice Mailing Address To: City ' Slate Z|page X of £ ““ 3 Credit Card # fxp. Date /r^ PAS Quoted/ Sampled by; n AirVol^ Marrix Date TJine 8 SAMPLE DESCmPTION ariiiiip Sfimpled Commenfs/Hazards/Location Details 1 V 2 I /6/ik AZ 3 /2 4 /&Zn 12 5 <1

’XI CD 7 CO

(M 8 CT (S 9 UD 10

Special Insfruetions (including Data Deliverables and Turn Around Time); CO n H CM Samples re]in(|uhlied to , Date , Jitne Saihipks Relinquished by; Samples Reiinquished to; Date I 'rime _^ii2££LSL££E!j£L^Xi-—— bO CO Samples received by; Date' , TiBie ' Samples Rehnguished by; I Samples ReliiitjuishaifX®;!^। Time I—* o 1 LdmrnotA': I /^Q S o Q CM Method of Shipment/Oelivery: TTPS ^ED-EJ^ PAS' Courier Client drop otf Other o o I Samples Rec’d. onice? ( Y N Tval Temp. Blank ___ Sampla Temp, Notes J 3 Samples rec’d in.tact?(Y N 1 Custody seats intact?! Y N n/a I ID on samples match COC?( Y N 1 i VQC Sampies have zero headspeceTf Y N n/a ) Samples properly preserved? ( Y M n/a ) ^1 '^1

NYC-WTC_000202591