NYC-WTC_000218452

NYC 9/11 Public Portal Document

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T, Chain of Custody Record Sample Container information IB or 4418 Pottsville Pike Reading, PA 19605 Bottle Type ZjT rc phone: (610) 921-8833 fax: (610) 921-9667 < G P IH 1 *—r N ANALYTICAL SERVICES # of Containers o Preserved? (Y/N) rc Name a iA, Report Conyany^^^ o Results M-Hme Addrasa^^^ m ai To; Z4^/6 T) (fl Nams Telaphona * n Send Conyony , Dept. □ IB Invoice Address » tc To: City Stete ZIP /^[Page y of i ft ss=ssasssnes Cratit Card « Exp. Dels PAS Quote# 0 fli Sampled by: ht / 'T' AirVoL(L Matrix Date Time or min) Type Sampled Sampled in I SAMPLE DESCRIPTION Coinnients/Hazards/ Location Det;iils It I air 3 I-*' 2 *Tc- „Jl Ij, lUkoo 44 fc*' 0 IB 3 Vt

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so Samples received by: Date I Time Samples Relinquished by: . Samples Relinquished to Date . Time I ------ S I I Lnboroloty: Q^IlliqUll lOJC- § Method of Shipment/Deiivei?: DT5 PA.S Courier Client dropoff Otlier_ZZZ ■0 CO Samples Rec'd. on Ice? ( Y (fstYnZTr^^* Temp. Blank " Sample Temp. — Noles: CO I Samples rec’d intact’f^^ ) Custody seals intact?! Y N ,1^^ I ID on samples match COC^y/Y^N ) Cn VOC Samples have zero headspace?! Y N ,7573 1 Sample-s properly preserved? ( V N /v/ay| co J

NYC-WTC_000218452