NYC-WTC_000208070

NYC 9/11 Public Portal Document

R5(Z PSC Analytical Services 4418 Pottsville Pike 3 SI a Reading, PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY Page x of Cl 1 c fax: (510) 921-9667 or 921-8407 PO# Quota # C

Report Name Company s PX W»~P-A ATC- C \a, J'r. Ctt. Tkr. ___ JOB ID: i£

c -h Results Mailing Address [^.C^ f:=- /oTU (f-Loi) r ANALYSIS REQUESTED Cu

To: CilyZ/eovv state ZIP /Oc^/0 Use attachments if necessary. Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid Company Submit C = HCI N2 = NaS2O3 Wailing Address H = HNO3 S =H2SO4 Invoice City state ZIP l = lce 2 = ZnAcetate To: T elephone # Fax# N = NaOH X = None Credit Card Info (include exp. date) Sampling Location (Specify State): Sampled by: u O = other: Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P-PIastic, G=Glass, A=Air)

u 2 SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Container Volume (Liter, etc) (ID must match container labels) Date Time Number of Containers 1 4/z/g^ m z/orTt 2 CJh 4Z//t->e lJl~ a I 3 arcl~'2‘\h~ 14^(1 XovCfS CD /• ro 4 I -S CD

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l"^ 8 9 S o to o o ¥(2) Received by: Date Time (1) Relinquished by: Date Time (3) Relinquished by: Date Time 1 o o TJ co (4) Received by: Dale Time (5) Relinquished by: Dale Time o IN

O Method of Delivery; UPS FED-EX PAS Courier Client US Mail Other CO

NYC-WTC_000208070