NYC-WTC_000221473

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike z-i Work Order # Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page i ot 1 fax: (610) 921-9667 or 921-8407 PO# Quote #

Report Name .\ (LO VV JOB ID: Company N-Vc- Results Mailing Address IOTE ^Lo(/r> ANALYSIS REQUESTED To: ,C''y /l/rx^ State /YZ ZIP /aofo Use attachments if necessary. Telephone# 2X2>e» 3ST. Please specify method requirements. Preservatives Key; Name A = Ascorbic Acid Company Submit C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice City stale ZIP -J I = Ice Z = ZnAcelate To: Telephone# Fax # N = NaOH X = None Credit Card Info (include exp. dale) — .............. -ly — — - ~ Sampled by; Sampling Location (Specify State);_____________ O = Other: Due Date: iZ (Rush TAT requires Lab approval) 53 REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preseivatlves (See above Key; list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic. 6=Glass, A-Mr)

I SAMPLE DESCRIPTION Final Air Volunn Matrix Type Sampling Info Containar Volume (Liter, etc)

(ID must match container labels) (L Dale Time Number of Containers ( 1 giy auJjC'Lt. ( 2 t 3 r 4 5 I t o 6 ( H

c S

S o 9 IO o o (3) Relinquished bJT I (1) Relinquished by: Dale Time (2) Received by: Date Time Dale Time o

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

Method of Delivery; UPS FED-EX PAS Courier Client US Mail Other Cn

NYC-WTC_000221473