NYC-WTC_000202723

NYC 9/11 Public Portal Document

Stu EDISON 777 New Durtwn Road Edison, New Jeraey 08817 CHAIN QF CUSTODY/ANALYSIS REQUEST Phone: (732) 549^3900 Fax: (732) 54d-3S7S PAGE__ OF__ Name (for report end fnwice) Samplers Name (P inled,) SHe/ProJod Idenlfficafiqii / « / ✓ \

P.O. # State (Location date): NJ: Q NY: 5^ Other. Regidatoiy Program: Knilyib TuraarMnd Tina ANALYaBKOtimDi < anat-vaaxMVTONicaEitEauECT) LAB USE ONLY aomJiidQ Protect No: / state Ruth Chargea AnftortzW Rr: ej /<d&^fcia.LJay________ 2***C /■k Job No: Phone Fax < Wtek® ^73 OStern_______

Sanipte Idenfllteatlon UP Su^ Pate Tima

r73u4e ISSD Matrix No. of. Cont ij X sW Sample Numbers

Prossrvsllon Used; 1 = ICE, 2 = HO. 3 = HiSO4, 4 « HNOj. 5 = NaOH Sol: /j Sa other 7-Olher Water:

o Spacial Instructions'^J^ > । । , Tn I 13 Water Malala Fliterad (Yes/No)? H Relinquishsd by Company Date / Time K Company I I—i IKZ / Z /ars-fJ, s o Relinquished by Company Date/Time Received by Company o o 2) L— ______ I Relinquished by Company Dale / Tima Received by Company O ' o i co o 3)__________ I 3)_______ Relinquished by Company i Date /Tima Received by Company I o ' 4) I 4> I

NYC-WTC_000202723