NYC-WTC_000214978

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page A of fax: (610) 921-9667 or 921-8407 PO# Quote #

Report Name J, JOB ID; Company Results Mailing Address 4^ (nCiVtZaxi Tv\C ■ i 0 TU r ANALYSIS REQUESTED To: State ZIP /ai^/O Use attachments if necessary. Telephone #^i j ?c"X R Z-So . j’y 3 . ^?e(> Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid Company C = HCI N2 = NaS2O3 Submit Mailing Address H = HNO3 S =H2SO4 Invoice City t state ZIP I = Ice Z = ZnAcetate To: Telephone It Fax# N = NaOH X = None Credit Card Info (include exp. date) r Sampled by: Due Date: Sampling Location (Specify State):

REPORTING REQUIREMENTS (Circle all that apply) /V (Rush TAT requires Lab approval) _______ I O = Other:

Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives' (See above Key: " list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P=Plaslic, G=Glass, A=Air)

stu SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Containef Volume (Liter, ett^ (ID must match container labels) (L «tgaisif Date Time Number of Containers

✓ 1 -O oL+- 1 c’t i'y Z 2 ATc-o36^~ ULr x AR - 3 All 4 Cc i LSiCAzA_________ __ 5 Q 6 H 7 K I 8 S o 9 10 o o I (1) Relinquished by: Time (2) Receive ^^linquished by: Date Time o o CO (4) Received by: ’cate Time (5) Relinquished by: 'Date Time (6) Received at Lab: Date Time cn co — cn co Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other iC.

NYC-WTC_000214978