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NYC-WTC_000208029

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000208029
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NYC 9/11 Public Portal Document

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Chain of Custody Record Sample Container Informstion 44-18 Potts Vil la Pike Reading, PA 19S05 Bottis Type phone: (610) 921-8833 fax: (610) 921-9667 1 G P IH ) t=:> 6? I ANALYTICAL SERVICES # of Containers _____________ ->°biD iq/2C-om\ Preserved? (Y/N) C=> </

Report compa.y :77yT/^s COt^^ ____________ Results h'Hilinu Audi055 To: p -'^/\iy -■•/Wo Telephone 30 6

Narns Telephone #

Send Invoice bailing Add,-ess V

To; Cily Stale ZIP Xi Page / of J Ciedil Card Exp. Data PAS Quote# Sampled by:'7?/9'^gytg^ Matrir Dale rinia Saaiplcd Sampled 0; SAMPLE DESCRIPTION ConimeiKs/HazardsZ Location Details

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7 V E 9 7 10 Q special Inslrucfions finduiSitig Dala Deliverables and Turn Around Time): H K I Samples relinqunhd I Dale , Time Samples Relinquished by: Samples RelinquiihciHo: j Dale I Time s Q shipper orcourierbv: Samples received by: JvVi*^ 1^0 mlJj — UDate Time Sample! Relinquished by: Samples Relinquished Z ^^wale , Time o o Lahnralory: I Mcihod of Shipmeni/Delivery: UPS ^FED-E^ PAS Courier Client drop otf Qdier o o LI I iMB fl i«i—B—>—3——ity^■—aMMja—mw— rT^i»„ co fi Samples Rec'd. on Ice? (Y Temp, Blank Sample Temp. _______ Nates: o co Samples rec'd intact^^^ ] Custody seals intact?! Y N^n/^ [d on samples match COC?^^^ ] co VOC Samples have zero headspace?! Y Samples properly preserved? ( Y N (OY, co

NYC-WTC_000208029

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NYC-WTC_000208029Source: NYC Law Department, mirrored locally

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NYC-WTC_000177925

Form recording the chain of custody for samples submitted to Analytical Services in Reading, Pennsylvania.

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