NYC-WTC_000203414

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike Reading, PA 19605 phone: (61Q) 921-8833 CHAIN OF CUSTODY Page A of fax: (610) 921-9667 or 921-8407 PO# Quote # SSBSSSSSBSSaSOS

Report Name JOB ID: 10k \ ^5 Results Mailing Address to Li- Ai < A ClOjG^ Company • e JLf 1k |Q TU /Ucr ANALYSIS REQUESTED To: Zb State ZIP famfo Use attachments if necessary. Telephone# g 2-ao Fax# JllJL . jyj . Please specify method requirements. Preservatives Key: Name

1 A = Ascorbic Acid Company Submit C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice city state ZIP I = Ice Z = ZnAcetate To: Telephone # Credit Card Info (include exp. date) Fax# Ar N = NaOH X = None

Sampled by: DueDate;(Rush TAT requires Lab approval) 7Sampling Location (Specify State):

REPORTING REQUIREMENTS (Circle all that apply) Af^_______ I O = Other:

Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list all thbt apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P-Plastic, G^GIass, A^Air)

SAMPLE DESCRIPTION Final Air Volum< Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L ecsOB^ Date Time Number of Containers

4Tc -o?of-r - Ml a <v __________ 2 ATc SpH - 2^ 4i’r 3 47c- c^irL- - ^3 ALL 4 AT<^- o3oCf Cl ■7 BifUAA. 5 Q 6 H 1"^ to 8 s O 9 ^1 01 in oi Io'i (1) Relinquished by: . > —— palp Time (2) Receivei ^„Jm^y^to^g^linquislied by: Date Time o co u/A' o (4) Received by: —^TiSte Time (5) Relkfquished by: Date Time (6) Received at Lab: Dale Time cn o Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other

NYC-WTC_000203414