NYC-WTC_000221471

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike Reading, PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY Page I of | fax: (610)921-9667 or 921-8407 PO# Quote#

(ig V<vc JOB ID: \ 1 - o Report Name Company Results Mailing Address (Q fC TU ANALYSIS REQUESTED To: city state ZIP Use attachments if necessary. Telephone #,£ (jg . Pax# g7d C Please specify method requirements. Preservatives Key: I Name A= Ascorbic Acid I

Submit Company C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice city state ZIP ■'i I = Ice Z = ZnAcetale To; Telephone # Fax# N = NaOH X = None Credit Card Info (include exp. date)

Sampled by; Sampling Location (Specify State): O = Other; Due Date; ______________________________ (Rush TAT requires Lab approval) 5 REPORTING REQUIREMENTS (Circle all that apply) 13 Reduced Deliverables Package Electronic Data Deliverables Pieseivatives (See above Key; ' Full Data Package list all that apply) UST NPDES MIPP RCRA Slormwater DEP (PWS# ) Type (P=Plastic, G-Glass, A-Ar)

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

(ID must malcli container labels) (L Date Time Number of Containers C 1 Z?/< hr litb— c 2 3 c r 4 5 t c o 6 t H 7 to » s O 9

o 10 o I (1) Relinquished by; Date Time (2) Received by: Date Time (3) Relinquished by: Dale Time o to T co (4) Received by: Date Time (5) Relinquished by; Date Time (6) Received at Lab: Dale Time co -J-Jlgtr&y- 9x51 r to Client to Method of Delivery: UPS ED-EX PAS Courier US Mail Other

NYC-WTC_000221471