NYC-WTC_000213007

NYC 9/11 Public Portal Document

r^SC PSC Analytical Services 4418 Pottsville Pike H3 T3 T

Reading, PA 19605 CHAIN OF CUSTODY IM to Phone:(610)921-8833 Page , ) of v o ro fax: (610) 921-9667 or 921-8407 PO# Quote # a ' — CD

Report Name ______ _ JOB ID: tq t <15 - O J'» 4 U Company L'rc (VSfCiLAoJi, Xvce 'J Results Mailing Address \oi4' 1^ iTyvAcr- (G VCv ANALYSIS REQUESTED IB

To: City /K.*c*v State ZIP Use aiiachmenis if necessary. Telephone# j^2. Please specify method requirements. Preservatives Key:

Submit Company Name

7^5 A = Ascorbic Acid C=HCI N2 = NaS2O3 1 Mailing Address H = HN03 S=H2SO4 Invoice City state ZIP l = ice Z = ZnAcelate To: Telephone # FeT# N = NaOH X = None Credit Card info (include exp. date) — Ill -I EH------------ . .11^ —R—— ■■ ■' . " I I"

1- Sampled by. Sampling Location {Specify Stats): Q= Other; . Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced D^iverables Package Electronic Data Deliverables Piesenratives (See above Key: li^aBIhal apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# } Type <P=Ptasbc. G^GIass, A=fisr}

S SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info Container Volume (Liter, etc) t (ID must match container labels) (Lh ffnnffl) Date Time Number of Containers 03 I Pu-jVT: U/Noo £tf< _ MflAAA-Lo kb^L i , 2 :. a 3 tfl 4 5 6 o S ; r- to . 7 « 9 gz:; 10

(1) Relinquished by: Date Time (2) Received by: Dale Y Tims Jjt3) Relinquished by; Date; ; Time

8 (4) Received by: Date Time 5) Relinquished by: Date Time (6) Received at Lab: \J Date Time m s <3 .. Method of Delivery; UPS z^ED-EX PAS Courier Client US Mail Other

NYC-WTC_000213007