NYC-WTC_000214349

NYC 9/11 Public Portal Document

I i PSC Analytical Services It U 4418 Pottsville Pike Reading, PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY Page [ of j c

c n fax: (610) 921-9667 or 921-8407 c PO# Quote # 0

Report Name JOB ID: G Company Kaj A t Results Maaing AddressiWo yz, £ Tl* ANALYSIS REQUESTED To: state Use attachments if necessary. Telephone # j.S'J. 2-‘i Please specify method requirements. Preservatives Key: 1 V Name A = Ascorbic Acid r Company Submit 5^ C:=HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice City State ZIP l = !ce Z = ZnAcetate To; Telephone ft Fax# N = NaOH X = None Credit Card Info (indude exp. date) Sampled by: Oc Sampling Location (Specity State): O - other

I 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; list alt that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P^PIactic, G^GIass. A^Airj

SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info Container Volume (Liter, etc)

(ID mil SI match container labels) Date Time Number of Containers tr I ^122 c

cr 3 ATE _________ A 4 Jf-Tc M -VoC-4^ I o 5 a O’ H cr K 6 I uo s O o o Io I!,' o (1) Relinquished by / Date Time (2) Received by: Dulc 11 me (3) Keiinquiblied by Date lrr;2 CO cn ________ TJ co Dale lime (51 Relifiquisftcd by. Date I Time (6) Received al I ab D.dc o (4) Received by 'jme u J'djl c ("^ED^EA ') PAS Courier US Mail Method of Delivery; UPS Client Other

NYC-WTC_000214349