NYC-WTC_000211808

NYC 9/11 Public Portal Document

PSC Analytical Services z (U 4418 Pottsville Pike T Reading, PA 19605 phone:(610) 921-8833 CHAIN OF CUSTODY Page t of 1 co

fax: (610)921-9667 or 921-8407 o ru PO# Quote ft □ Report Name \c>.v>x&A T20 Vr A____________ JOB ID: Company jcSiOCJUntf^i • U Results Mailing Address ypty E 10 TV • ANALYSIS REQUESTED U3 TJ To: City A/e4u /i>r^ Slate ZIP /60/b Use altachmenis if necessary. Telephone If q 8 S/Lo JiliL- 3^3- 23^6 Please specify method requirements. Preservatives Key: Name T3 A = Ascorbic Acid tn y n Submit Company C = tlCI N2 = NaS2O3 Mailing Address H = HN03 S =H2SO4 J3 Invoice - □ Slate ZIP tu

I Cily I = Ice Z = ZnAcelale To: Teleplione ft Fax ft N = NaOH X = None (£ Credit Card Info (include exp. dale) r+

Sampled by: x TfevixtM Sampling Location (Specify Slate): //' / O = Olher:___ n A) Due Date: (Rush TAT requires Lab approval) •kJ REPORTING REQUIREMENTS (Circle all that apply) Preservatives (See above Key: s? (Il Full Data Package Reduced Deliverables Package Electronic Data Deliverables T list all that apply) C UST NPDES MIPP RCRA Stormwater DEP (PWSff ) Type (P=Plastic, G=Glass, A=Air) o ID W i»c SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L .Mill) Date Time Number of Containers I J’ 1 /Irt-O3ol- ” iTHT O /HAIA LobUa tn /o^o ai'r’ sr Pa ^/oor LeWy Q ^0 o fF VflTtC Ufa, (D i /irc-ojdl- -53 HiY' ro •I 4r^-ojot - a I'l^ • t rSfemA tn 5 tn m 6 7 n 8 9 in n o (1) Relinquished by: Dale Time Ite Time, ’3) Relinquished by: Date 1 iriic o I Time (5) Relinquished by- / Dale De r Time (6) Received al Lab: Dale o 1'1) Received by: Dale Time TI o o ru Method of Delivery: UPS ED-EX PAS Courier Client US Mail Other

NYC-WTC_000211808