NYC-WTC_000221470

NYC 9/11 Public Portal Document

esc PSC Analytical Services 4418 Pottsville Pike S Reading, PA 19605 CHAIN OF CUSTODY PSC Work Order # 35 T! 1

phone; (610) 921-8833 Page / f of { □ w fax: (610) 921-9667 or921-84Q7 a PO# Quote # CD JOB ID: Report Name w Company lU Results Mailing Address ANALYSIS REQUESTED To: City /yv State /yvFax # ZIP Use attachments if necessary. Telephone# 2/ 2<3 - 2 Please specify method requirements. Preservatives Key: TJ W

Submit Company Name 1 A = Ascorbic Acid C = HCI N2 = NaS2O3 n

Mailing Address H = HNO3 S = H2SO4 Invoice city State. ZIP l = lce Z = ZnAcetale To;

i Telephone# Fax# N = NaOH X = None Credit Card Info (include exp. dale)

Sampled by: Sampling Location (Specify state): O = Other:

Due Date; (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Electronic Data Deliverables Preservatives (See shove Key; ' Full Data Package Reduced Deliverables Package list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G=Glass, A=Air)

SAMPLE DESCRIPTION Final Air Voliiint Matrix Type I Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L'»i “ iiiiri)’ Date Time Number of Containers ff Pt, C 2 L/ I U 3 h

4 J 0 Q £ H 6 K I 7

s £ a 9 o o. 10 I o Time 11(2) Received by: Dale Time (3) Relinquished by; Date

A o (1) RBhnquishedby^^,^^ Time CO CO (4) Received by: Dale Time [(|5) Relinquished by: Dale Time (6) Received al Lab; Date Time co to £72;^ 7^ Methoid of Delivery: UPS /^ED-EX PAS Courier Client US Mail Other

NYC-WTC_000221470