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NYC-WTC_000208000

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000208000
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NYC 9/11 Public Portal Document ALID II8LI0 00 1 Pace Analytical" www.pacelabs.com Required Client Information: Section A Company Required Client Information: Report To: James Section B Cohn ATC Associates Inc Copy To: A /04 E 25th street Invoice To: 10th floor P.O. Newtork, NY 100/0 Proiect Name IS 131 M 212.353.8280 212.353.83061 PN 9995-03464342 Section D Required Client Information: Valid Matrix Codes 4- MATRIX CODE WATER WT SAMPLE ID SOIL SL ITEM # OIL OL WIPE One character per box. WP (A-Z, 0- 9/.-) AIR AR TISSUE TS Sample IDs MUST BE UNIQUE OTHER OL. MATRIX CODE 4TC-0822-131m -DX 2ATC-0822-131M-DX 2 3AТC-08.22-131 M-РX 3 4ATC-0822-131M-DX4 AI 'DEISTODY' "na "ica' Reqest ~-cur-nt The Chain-of-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Page: / of 647714 To Be Compieted by Pace Analytical and Client Section C Quote Rleference: Client Information (Check quote/contract): Requested Due Dale: *TAT: Project Manager: * Tur around limes less than 14 days subject to laboratory and contractual obligations and may result in a Rush Turnaround Surcharge. Turn Around Time (TAT) in calendar days. Projact #: 1061758 Profile #: ¡Requested Analysis: DATE COLLECTED TIME COLLECTED Preservatives #Containers Unpreserved H,SO, HNO3 HCI NaOH Na,$,0z Methanol Other DloXin mm/ dd/ yy WP 8/22/4 / m' Im= Im2 Blauk Remarks / Lat Main Kably 38003 and floor Hall by 210 350039 3nd floor. Hallky327 •4C Blank 41 5 GATC-0823-2M-DX-/ IATC-0823-2M-DX-2 BATC-0823-2m-DX-3 wpp 8/23/02/mz we Im2 Main Losby 3800421 wdl. hallevay by oit 2433801 1511. hallaicy byext 6 38004 10 11 12 SHIPMENT METHOD Fedex SAMPLE CONDITION Tempin c 2u Received on ice YN Sealed Cooler ITEM AIRBILL NO. SHIPPING DATE NO. OF COOLERS NUMBER - - 0870 /8/23/02 SAMPLE NOTES RELINQUISHED BY / AFFILIATION | DATE WATDI/ATC 8/23 TIME 1:30р ACCEPTED BY I AFFILIATION Ban Bet DATE TIN 8-74-84 1L Samples Intact Additional Comments: SAMPLER NAME AND SIGNATURE PRINT Name of SAMPLER: SIGNATURE of SAMPLER: Wagde WAGDT DATE Signed: MM/ DD/YY 8/27/02 NYC-WTC_000208000

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NYC-WTC_000208000Source: NYC Law Department, mirrored locally

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