NYC-WTC_000221474

NYC 9/11 Public Portal Document

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

Report Name JOB ID; Company C-WL Results Mailing Address [q c/--ft-iTiOCUtxfcz' J ANALYSIS REQUESTED /a To: Q*y y(AState y Use attachments if necessary. Telephone# <^6 Please specify method requirements. Preservatives Key; Name A = Ascorbic Acid

Submit Company C = HCI N2 - NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice city state ZIP Z = ZnAcetaie I = Ice To: Telephone # Fax# N = NaOH X = None

I ^==:=:= Sampled by: Credit Gard Info (include exp. date) Sampling Location (Specify State): 1 0 = other:

I Due Date:

Full Data Package REPORTING REQUIREMENTS (Circle all that apply) Reduced Deliverables Package (Rush TAT requires Lab approval)

Electronic Data Deliverables a PrsservMveT (Sae above Key: list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type lP=P.3stic, G^GIess. ArAir) ) 2 lu SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Container Volume (Liter, etc) H (ID must match container labels) (L or min) Date Time Number ot Containers r 1 /irc- oSa?^ 81M - a/K T ( 3 ( 4 ( I 5 6 ( o I H 7 ( 8 9 S o 10 o o (2) Received by: Time I (1) Relinquished by: • . y Dale Time Date Time (3) Relinquished by; Date o o (4) Received by: ly Dale Time (5) Relinquished by: Date Time [6) Recanted atteb: Date, Time n CO CO //A^ co r Method of Delivery; UPS FED-E PAS Courier Client US Mail Other r

NYC-WTC_000221474