NYC-WTC_000203426

NYC 9/11 Public Portal Document

ZZrl HS| PSC Analytical Services 4418 Pottsville Pike PSC Work Order # 33 tJ Reading, PA 19605 CHAIN OF CUSTODY Page □ T

phone; (610) 921-8833 I 10 fax: (610) 921-9667 or 921-8407 o PO# Quote # ro JOB ID: □ Report Name Company AAX- MTaCtotfa Tv^c Results Malling Address flC f rj^oe K ANALYSIS REQUESTED 01

To; Ciiy Slate ______ ZIP /oo/o Use attachments if necessary TJ

Telephons 7* rax# 6 Please specify mefhod requirements Preservatives Key: Name A = Ascorbic Acid TJ w Submit Company Mailing Address Invoice Eii^T 5 C = HCI H = HNO3 N2 = Na S 203 S -H2SO4 n

Slate ZIP 1 = Ice 2 = ZnAcelale To; Telepitone# rax« N = NaOH X = None Credit Card Info (include exp. date)

Sampled by: Sampling Location (Specify Stale): O = Other

Due Date. (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) I Full Data Package Reduced Deliverables Package tleclronic Data Deliverables Preservatives (See above Key: list an that apply) LIST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P^PIaslic, G=Glass. A=Air) % 2 SAMPLE DESCRIPTION Final Air Vohimt Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L nr min) Date Time tJumber of Containers

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o (1) Relinquished by , Time 1(2) Received by: Dale Timo (3) Relinquished by: flute time o I ____________ /V o o |4) Received by: Oale Time (5) Relinqiiished by: Dale Time Date rime co >A5hC9- TJ o Oh co TT w Method of Delivery: UPS ED-EX PAS Courier Client US Mail Other tn o

NYC-WTC_000203426