NYC-WTC_000214927

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order# ( [

Reading, PA 19605 CHAIN OF CUSTODY phone: (610) 921-8833 Page of । fax: (610) 921-9667 or 921-8407 r c

PO# Quote S ( Report Name_________ JOB ID: Company C'r i rr JtlT; T.\a<i Results Mailing Address j ANALYSIS REQUESTED C 1 To; City zfZV State /d?e>/'o Use attachments if necessary. Telephones g (/.Js' j . k 2-Z c ’jty 6 Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid t I f Submit Company C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice City State ZIP I = Ice Z = ZnAcetate To; Telephone # Fax# N = NaOH X = None Credit Card Info (include exp. date)

I Sampled by: '■^Sampling Location (Specify Stale): O = Other

Due Date: (Rush TAT requires Lab approval)

REPORTING REQUIREMENTS (Circle all that apply)

Full Data Package Reduced Deliverables Package Electronic Data Deliverables Prahrvatlves (See above Kay: ' Ost aft that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic. G=Gtess. A=Air) % s SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info ContainerVobime (Liter, etc)

t (ID must match container labels) (L Dale Time Number of CantabKfs ^«:T> 45» J I Ue Ait 0 4 2 Ari: —o Aef a C I 0 n 5 I 0 0 0 7 n I—I 8 H l"" 9 10 S n (1) Relinquished by: /. f Z Date Time (2) Received by: Date Time (3) Relinquished by: Date Time o I ______________ (4) Received by: (J Date Time (5) Relinquished by: Date Tima (6) Received at Lab: , Date —Tirne t o n Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other n (jn

NYC-WTC_000214927