NYC-WTC_000211851

NYC 9/11 Public Portal Document i:: : 1S YTHALDOR SUSTODY Anc., lica. Regoust -jcu.unt Pace Analytical™ www.pacelabs.com The Chain-of-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Regulred Client Information: Section B Report To: 625144 Required Client Information: Section A ames Cohn Page: of To Be Completed by Pace Analylical and Client Section C Company ATC Associales Inc Copy To: Quole Reference: Address Client Information (Check quote/contract): 104 E25ph s/reet. Invoice To: Requested Due Date: "TAT: Project Manager: 10 Th floor P.O. • Turn around times less than 14 days subject to Project #: laboratory and contractual obligations and may result in a NewYouke, N/ 10010 Project Name: M 894 1056604 Rush Turnaround Surcharge. Prolile #: Turn Around Time (TAT) in calendar days. 11.353.8280 Project Number: 212.353.830 19125-0290 Requested Analysis: Section D Required Client Information: Valid Matrix Codes +- MATRIX WATER CODE WT SAMPLEID SOIL OIL SL OL ITEM # WIPE WP One character per box. AIR AR (A-Z, 0-9/.-) TISSUE TS Sample IDs MUST BE UNIQUE OTHER. OT A TC 4/9-M89 4 MATRIX CODE DATE COLLECTED mm/ dd / yy WP 4//9/02 TIME COLLECTED Preservatives # Containers Unpreserved H,SO, HNO HCI NaOH ￾Na¿S„0ą Methanol охін Other 2ATC-0419-M8944 DX2 3 ATC-041 129043 VP (m2 1m2 Remarks / Lab ID мат Lobiby 103481388 Sthpon Elv Lobby 1103481396 LorE(ZLobz 5103401484 6 7 8 9 10 11 12 ALID ОNIZ 969998700 SHIPMENT METHOD Fedex SAMPLE CONDITION Temp in °C 115 AIRBILL NO. ІTEM SHIPPING DATE NO. OF COOLERS IUMBER RELINQUISHED BY / AFFILIATION DATE TIME ACCEPTED BY / AFFILIATION DATE TIME Aades Mond 4h0102 4:30 SAMPLE NOTES Received on Ice ese the Same Black Sealed Cooler Samples Intact Additional Comments: These saupls ORIGINAL SAMPLER NAME AND SIGNATURE PRINT Name of SAMPLER: WAGDT SIGNATURE of SAMPLER: Altagot CEE DEVEDCE CINCEND INCTDIIATIAAIC DATE Signed: (MM/DD/YY) 41191º2 .Currm CArt Oa. nans NYC-WTC_000211851