NYC-WTC_000205315

1^X9 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike PSC Work Order#

CHAIN OF CUSTODY bO Reading, PA 19605 ND NJ phone: (610) 921-8833 Page o t- A © fax: (610) 921-9667 or 921-8407 FT

PO# Quote# J? Report Name 'D; <9 J hO cn Company R T- G. Px A V'os TT^ Results Mailing Address! K O b, & ± S' /u ----- ANALYSIS REQUESTED To: , state A^y ZIP Use attachments if necessary. on © Telephone» Please specify method requirsments. l£t Preservatives Key; ra Nams A = Ascorbic Add OJ cn Submit Company C = HCI N2 = NaS2O3 cn --J Mailing Address invoice city state ________ ZIP H= HNO3 S = H2SO4 I = Ice Z = ZnAcetate To: iTelefihona # Fax« N = NaOH X = None iCredil Card Info (Include exp. date) Sampled by: "T"^ Sampling Location (Specify State);_____________ 0 = Other: iDue Date: (Rush TAT requires Lab approval) REPORTING RE(2UIREMENTS (Circle ail that apply) Full Data Package Reduced DeliveraSles Package Electronic Data Deliverables

s ■UST NPDES MIPP RCRA Stonnwal^r DEP (PWS# ________ H =tt SAMPLE DESCRIPTION Final Aii Volumi Matrix Type Sampling Info t g (ID must match. co:atainer labels) Date Time 2^ _1_ fi-Tc - lUU - peg 1 ■■ MH mmBB 2 -J .Cat^ o 2 A & 4 I I H

T ED & S o o X 1^ 9 o LO 10 ND T O I (1) Relinqu'tshed by;__ , Date Time (2) Received by: iDate Time 1(3) Helinqutshsd by; c CO Date Time r ________ "p-etzjAft (4) Received by; Date Time J(5) Relmquis-hed by: (Dale Time (6) Receive;? at Lab: ■ Date Time 1 c un514 iiS\n NYC-WTC_000205315