NYC-WTC_000218470

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order# 3 Al T

Reading. PA 19605 CHAIN OF CUSTODY Rc2.6 ro u Phone:(610)921-8833 Page 2 o fax: (610) 921-9667 or 921-8407 ro PO# Qu<4e» o 03 Report Company A^TC YtS jL m Results Mailing Address J()i^ ANALYSIS REQUESTED u To; ’ ZIP 7b2?/^ Use attachments if necessary. letephone 9 p”* Please specify method requirements. Preservatives Key; Name A = Ascorbic Acid Company Submit C = HCI N2=NaS2O3 Mailing Address H = HN03 S = H2SO4 Invoice City state ZIP > l = lce Z = ZnAcelale To: Telephone 9 Fax# '' N = NaOH X = None I Credit Card Info (Include exp, date) Sampled by: Due Date; / Sampling Location (Specify State): /W (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) I' O = Ottier:

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-~Plastic, G=Glass, A=Air) st 2 SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (T. UI min) Dale Number of CMilainers

I Arc-oy i/oc, 2 AxZ^'Vtiy — 7 3 Soe? 4 kZ

Q 5 6

I R 9 o 10 I o o (1) relinquished by: Time (2) Received by: Date Time (3) Relinquished by: Date 1 inie CO

(4) Received by: Date Time (5) Relinquished by: Dale Time (6) Received at Lab: ■c CO

tLs O m Method of Delivery: UPS FED-EX 'AS Courier Client US Mail Other

NYC-WTC_000218470