NYC-WTC_000208120

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike PSC Work Order# 03

0. Reading, PA 19605 CHAIN OF CUSTODY P.O^.OOO^CT^' phone: (610) 921-8833 Page 1 of fax: (610) 921-9667 or 921-8407 PO#________________________ _________ Quote #____________________ l^ame (<2> Vma JOB ID: - Report Company ClO^ T C._______________________ Results Mailing Address [QQ r- S 101^ ANALYSIS REQUESTED (0 (D To; City /l/eg^ ya/'/i, Stale ZIP /Onfo Use attachments if necessary. tn Telephone _ ^28c I 3^3 . Pleasespecity method requirements. Preservatives Key:

M in □ I Submit Name Company Mailing Address Invoice City sw A = Ascorbic Acid C = HCI H = HNO3 N2 = NaS2O3 S =H2SO4 to state ZIP I = Ice Z = ZnAcetate To; Telephone tt Fax # N = NaOH X = None Credit Card Info (include exp. date) ”"^- " ' ——————--------- 1 Sampled by: Sampling Location (Specify State): Ch 0 = Other: Due Date; __________________ _________ (Rush TAT requires Lab approval) |(J REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables PresonrSlms'(See above KeiE' Het all that apply) UST . NPDES MIPP RCRA Stormwater OEP (PWS# ) Type ‘t^asBc^=GlBss. a'^)'

;s SAMPLE DESCRIPTION Final Air Volumt Sampling Info Container volume (Liter, etc) Matrix Type H (ID must match container labels) Date Time Number of Containers I 2 4Ec 6' /yoM- j, 3 u (A 4 0. 5 7 Ar 1 6 o al 2- H w 7 57 ft- □ S 7^ I—i 9 s o o 10 o OJ o o Time I (1) Relinquished by: Dale time (2) Received by: Date (3) Relinquished by; Dale Time o o w co o w (4) Received by; Dale Time (5) Relinquished by: Dale Time Dale Time

O 3) n O E Method of Delivery: UPS FED-EX PAS Courier Client US Mail other CO

NYC-WTC_000208120