NYC-WTC_000208119

NYC 9/11 Public Portal Document

F’SC PSC Analytical Services 4418 Pottsville Pike PSC Work Order # Reading. PA 19605 CHAIN OF CUSTODY phone: (610) 921-8833 Pas© I of I fax: (610) 921-9667 or 921-8407______________ POff Quote #

Report Name A LX. YA4>/\ L O xV Vs. ID: /^Z/X Company Results Mailing Address (^(>3 tf Tk. ___________________ ANALYSIS REQUESTED To: City state Use attachments if necessary. Telephone#^ 11 , L 22^2,0 3 Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid

Submit Company S’0^ C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice City state ZIP 1= Ice Z = ZnAcetate To; Telephone # Fax# N =NaOH X = None Credit Card Into (include exp. dale) C12 Sampled by; __________ Sampling Location (Specify Stale):________________ O = Other: Due Date; ____________________________(Rush TAT requires Lab approval) (J REPORTING REQUIREMENTS (Circle all that apply)............ '' a. Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preseryatives (See above Key; nst an that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# I Type (P-Plastic, G=Glass. A=Air) % st SAMPLE DESCRIPTION Final Air Volumi Matrix Type (ID must match container labels) Date Sampling Info Time Container Volume (Liter, etc) Number of Containers 1 /do u/1 2 3 4 5 o 7 6 ( Th H l"^ 7 I 2 yf to (—- 8 S O 9 o J 10 o I o o (1) Relinquished by: . Data Time (2) Received by; Date Time (3) Relinquished by; Date Time -c co o to (4) Received by: Date Time (5) Relinquished by: Date Time (6) Received at Lab: _ Date Time 4 o o co nk/oz to Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other

NYC-WTC_000208119