NYC-WTC_000203030

NYC 9/11 Public Portal Document

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in RStZ PSC Analytical Services 4418 Polisvilie Pike PSC Work Order # o fl- Reading, PA 19605 CHAIN OF CUSTODY Page phone: (610) 921-8833 L of 2— fax; (610) 921-9667 or 921-8407 PO# Quote » C9 2: Report Name FrcA Rirfe/joKA^- ID; /as CkAc/T' Company Q a Results Mailing Address ST ANALYSIS REQUESTED u q: To: City____________________________ Slate /sV ^'P luolU Use attachments if nacassary. u Telephone It ’ Faxff Please specify method requirements. Preservatives Key: tn 0. Name A = Ascorbic Add

O Company C = net N2 = NaS2O3 Submit Mailing Address H = HNO3 S = H2SO4 cn ID Invoice City stale ZIP l = lce Z = ZrtAcetaie

cn To: Telephone fl Fax* N = NaOH X = None

rd Credit Csid Into (include exp. date) rj '2 s n Sampled by: Sampling Location (Specify State):_______________ O = Oifiei;

Due Dale: (Rush TAT requires Lab approval) tn o REPORTING REQUIREMENTS (Circle all that apply) u cr Preservilves (See above Key; ' o Full Data Package Reduced Deliverables Package Electronic Data Deliverables

UST NPDES MIPP RCFtA Stormwater DEP (PWS # ) <I r S SAMPLE DESCRIPTION Final Air Volumi Malrix Type Sampling Info Container Vaiuma (Uer, efet ' ■- a (ID inur.l iiialt.li container labels) (1 or-rmTi) Dale Time Number of Containers 0- PVl-p- \A/ 2 X 2 - H 0- -1 tOQyliQ.R or 4 J iL 5 ------ o LPt a 6 -y H OJ in 7 / ' P - LaJ CT M. to 2 -H jo s O CD 9

o (\j 10 12 H - D-us .IT o Q I (3 (1) Reliaquiehsd by: Dale lime ;21 Received by. Dale Time .3) Relinquished by; Dale TirriE o CM o co Q (4) Received by; Date Time (5) Relinquished by: Dats Time (6) Received al Lab; Time o n ( it^TO o 0- o UJ cn Method of Delivery; UPS FED-EX PAS Courier Client US Mail Other

NYC-WTC_000203030