NYC-WTC_000218451

NYC 9/11 Public Portal Document

FSC 4418 Pottsville Pike Chain of Custody Record Reading, PA 19605 Bottle Type Samp/e Container information -n r» tr

phone: (610] 921-8833 fax; (610) 921-9667 I G P IH I y ANALYTICAL SERVICES # of Containers □ W Preserved? (Y/N) CZ> Nam* cxnv<€>' Go Vs v< □ Report Company td Results MaiHne Address tD 01 i To; ! Telephone T3 yj Name Telephone t n Oept. 35 Send □ Invoice MaWnB Address ^Ci7.g2gW- 01 I—' (£ To; City St#t» ZIP yjPage _x_ of I ft Gradit Card It Exp. Date PAS Quote// 0 U Sampled by: __________ Air Vol. (L Mulrix Date Tbne SAMPLE DESCRIPTION Typr Snnqileil Sampled Cointnenls/Hazards/ Location Details w I I# I ATc- cJcc Zp ..2 4 - fwlf 44^ c M' 2 at? n ft 3 in I 4

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Special Instructions (including Outa Deliverables and Turn Arnund Time):

S o I—i Samples relinquished In Samples Relinquished by; Samples Rciin(|ujshed to: I Date I Time o shipper or courier by: o 1^ .Samples received by. I Date I Time Samples Relinquished by: Samples Relinquished Io X ^l”/' I • o I Laboratoty: I 730 Meihod of shipmenvuciiveiy: OTS (T^D-EX^PAS Councr Client drop off Other CO T5 CO on Samples Rec'd. on Ice? ( Y ^^^n/a) Temp, Blank Sample Temp. __ -7 _ Nules : cn Samples rec'd intacl?GN ) Custody seals intact?! V N @ ) ID on samples match COC?^N I m — hparisnnce?! Y N ,rf/a1| Samples properly preserved? ( Y hJ /fV^)

NYC-WTC_000218451