NYC-WTC_000215143

NYC 9/11 Public Portal Document

Chain of Custody Record Sample Container Information C-i . tu □ 4418 Pottsville Pike Reading, PA 19605 Bottle Type _a Q phone: (610) 921-8833 fax: (610) 921-9667 ( G P IH ) *—/ 'J ANALYTICAL SERVICES # of Containers -7" O |po # Preserved? (Y/N) ro Name 'co Report Company 777/^1/00 6:0/6/V .ft

Results Meiling Address /77C- tn tn 5^?^^ TJ To: /Vw y^ state

Telephone <»'2^-?'?>O 6? T Name Telephone # CD n Send Company

Invoice

To: Cily Address State ZIP ifoZn too 16 X|Page , / of / □ (U H-1

t£ f+ M. Credit Card # Exp, Date PAS Quote# 0 01 Sampled by; Air Vol. (b Matrix Dale Time Type Sampled Sampled tn SAMPLE DESCRIPTION / Commenis/Hazards/ Locnlion Details 10

o * i /.6O 6 ZSZZ5^S~S5SZiZ T < f e> 2 L/600 X Iz^SLZZ^^xZZZZZZ 11'^706} Wo I' 0 ID Bi a 3 6(^1 X W 4 6C66K tB 6 5 606) A cn 6 60/ ^E^SZZ^KKIZZZZZZZ □ CD iff £> 7 ru 8 < ep '1 '1 ' CD 9 cn tn o' H 10 l)-TC -/2^ 0-^7'ini "6^3If- V

Special Inshuclionj (including Data Deliverables and Turn Around Time); z to (—1

S “sSrop^MrtHnq^^ Date , Time Samples Relinquished by; Samples Relinquished Io: Date I Time O shipper or courier by: I I o Samples received by: Date Time Samplc.s Relinquished by; Samples Relinquished to / Date , Time o I o Method or Shipment/Dclivery: tjPS PAS Courier Clientdr^otf Other ' I Laboratory: - tM o to TJ co Noles: cn . Samples Rec'd. on Ice? ( Y NCri/al Temp. Blank _____ Sample Temp._____ . Samples rec'd intac^i^^N ) Custody seals intact?( Y NC^i/^l ID on samples match C0cAy?N ) ro co co VOC Samples have zero headspace?! Y N (Sa^ Samples properly preserved? ( Y NCn/a)|

NYC-WTC_000215144