NYC-WTC_000212678

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike > PSC Work Order # Reading, PA 19605 phone. (610) 921-8833 CHAIN OF CUSTODY Page j of { tax- (610) 921-9667 or 921-8407 PO# Quote «

Report Name ID; /f/J 5'- O'J Company Results Mailing Address ANALYSIS REQUESTED I To; Chy /at < Slate Use attachments ii necessary. ) Telephone# Please specify method requirements. Pteservaiives Key J Name A = Ascorbic Acid J Submit Company Q C = HCI N2 = NaS2O3 ) Mailing Address H = HNO3 S = H2SO4 invoice Cily Stale ZIP I = Ice JZ = ZnAceiaie To: Telepltone # Fax# N = NaOH X = None Credit Card Into (include exp. date,

I Sampled by: Sampling location (Specify State);_______________ 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; tst atithat apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P^PIastK. G=Glsss A'^Air)

s LU SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Container volume (Liter, etc) (ID must match container labels) (L OBmwn} Dale Time Number of Cottlahers I fin MI / jL g l/ftfci i At _______ _ i 2 7^0 o 3 /r?«- u tn 4 f z n 5 z ____________ 6 I" v Q 7 A®-

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oU (1) Relinquished by: Date time (2) Received by: Dale Time (3) Relinquished by. Date Time 1°’ §0 (4) Received by: Date Time !5) Relinquished by: Dale Time (6) Received at Lab: Dale Time mJ co

Method of Delivery: UPS (PW-EX^ PAS Courier Client US Mail Other co’ o

NYC-WTC_000212678