NYC-WTC_000214979

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike PSC Work Order# tn (^07.03^ IMS' a. Reading, PA 19605 phene: (610) 921-8833 CHAIN OF CUSTODY Page U of 1|- ___________ fax: (610) £21-9667 or 921-8407____________ PO Quote#

Repert >^arre__________ CqVv-_______________________________________________ JOB ID: ____________ ___ Results Conyany Wailing Address LTC -UoatArcXM jk ANALYSIS REQUESTED ra To; qiy /arAc. state zp /c:>ci/o Use arachmenls if necessary. r> Tele.jhone# yyy. ^1^0 Please specify mehod requirements. /^/eservatives Key: in tn Name A = Ascorbic Acid tn Submit Conpany C = HCl N2 = NaS2O3

I tn □ Wailing Address H = HNO2 S = K2SO4 Invoice tn cnT State 2P ! = Ice ;Z = ZnAcelate To; Teteihoue S Fan S 14 = t4aOT X = Norse Ciecil Card Infr (include exp_ dale) SampledTyT^_______ O = Other; Due Date: (Rush TAI requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatkes (See above Key; list all that apply) UST HPDES MiPP FiCRA Stormwalar DEP ;PWS # ) Type (papistic, G^GIass. A=Ar) C SAMPLE DESCRIPTION final Air Volunit Matrix Type Sampling Info Container Volume (LHer. etc)

X (ID miisl match container labels) (L Dale Time ^r Number ol Container o <0 oa (9 / pI ] f^O O ^00 VI <b E nt 4 Zo o szzzzzzzzzzzz n 5 6 O H <0 S ,k: ro I to 9 ___J

10 IS s o o o t\i {!) Rslinouished by: Tine <2) Received ay: Dale Time (3) Relinquished by: Dale Time o I o o (4) Received by; Dale Tirie (5) Relinquished by; Date Time (6) RecsivetJ 1 Date Date rime o txj co o ^>7 w c Method of Delivery; UPS FEDEX PAS Courier Client US Mail other / ' cu E UI ~ co CE

NYC-WTC_000214979