NYC-WTC_000208050

NYC 9/11 Public Portal Document PO# Quote # Report [Name Awen Cow JOB ID: \A\25 - GA =: Results (oma ATC Kssouat, Tre Mailing Address \o y E 2S Th ST rat 10% voor ANALYSIS REQUESTED: TO: City VA tu Ya YR State WY zP /o0/O Use attachments if necessary. Telephone #9 (9. 253. ¥290 Fax# 97 &. 253. #704 Please specify method requirements. Preservatives Key: Name 9 A = Ascorbic Acid Submit [Company ZAM u C=HCI N2 = NaS203 ._ [Mailing Address = (0 + H = HNO3 S =H2S04 Invoice |- ; City State ZIP 8 }=Ice Z = ZnAcetate To: Telephone # Fax # Q N = NaOH X = None Credit Card Info (include exp. date) & Sampled by: ¢/agod: S TéuUz14 Sampling Location (Specify State): 2 O = Other: Due Date: . (Rush TAT requires Lab approval) 8 REPORTING REQUIREMENTS (Circle all that apply) > J Full Data Package Reduced Deliverables Package —_—_Electronic Data Deliverables ee [~ Preservatives (Sea above Key, as a en ne ee ahd fist all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) r r “(7 ( TT [iype (P=Ptastic, G=Giass, A~Ai) | oe fee oe, er amet chameleon i me es ne ed ew ar me a a te a ar ol =| SAMPLE DESCRIPTION | Final air Volumg . Sampling Info Container Volume (Liter, etc) fa Matnx Type aoe eer mar by amar er ene be ee ‘honnl and aed and aed _ _ AE OE A OE tO a see at later “ fe (ID must match container labels) (L qrcusm) Date Time ; : 1 : Number of Containers | |Afe-o3A3- PIM ~ Mi (foo Grr | 3/9alesl Gos | Bret playgrowe Nor hi 2 |ATe—o?238- 89M— ML [co goo | Play greed South 3 | Aye 03 I$ 8— sah¢— M3 / B00 foo |W V how) ondrs'd Cadttin 3 4 Wqge—oPAS—JYIMN- MY | /hoo | goo |v Root 5 [Arc a2Ig- 39U- MS | Blank 4 | Aayd | Black | 4 : a 7 4 ft : 9 N — iS ae I Bs fo) (1) Relinquished by: Date Time {{2) Received by: Date Time (3) Relinquished by: Date Time e A/ AT fi = (4) Received by: Dale Time (° Relinquished by: Date Time (° Received at Lab: - Date Time 3 eats Yhloz | PIS © Method of Delivery: = UPS FED-EX PAS Courier Client US Mail Other ~] _— NS ~_-- ra ia i 4 at — | Y ny PSC Analytical Services - 4418 Pottsville Pike Reading, PA 19605 phone: (610) 921-8833 fax: (610) 921-9667 or 921-8407 CHAIN OF CUSTODY PSC Work Order # Rolopgo Page | of | NYC-WTC_000208050 eWNzo:so0 20 OT dy Sd £996-1T26-O0TS