NYC-WTC_000222462

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike X? PSCkork Order#

Reading, PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY Page / of ' fax: (610) 921-9667 or 921-8407 PO# Quote #

Report Name JOB ID: / 7/ 2 V - Company Results Mailing Address 1/ J/ • ANALYSIS REQUESTED To: City /V y State^ Ay ZIP Use attachments if necessary. Telephone# -- ----- ------- £ Please specify method requirements. Preservatives Key: Name A = Ascorbic Add

Submit Company C C = HCI N2 = NaS2O3 Mailing Address f H = HN03 S =H2S04 Invoice citJ Stats ZIP l = lce Z = ZnAcstate To: Telephone# Fax# N = NaOH X = None

I Credit Card Intb (include exp. date) Sampled by: / fASa fe^ ' Sampling Location (Specify State): 0 = Other: Due Date: ' / " (Rush TAT requires Lab approv^

REPORTING REQUIREMENTS (Circle all that apply) I Full Data Package

UST NPDES MIPP Reduced Deliverables Package

RCRA Stormwater Electronic Data Deliverables

DEP (PWS# ) I SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info I (ID most match container labels) (L nr niin)- Date y»/z>T°ne » 1 4 2 4 3 4 1/ 6a b 5 1/ 6 Q ! 7 H 8 I—i 9 s 10 o I—i o o (1) Relinquished by: Time {2) Received by: Date Time ’3) Relinquished by: Date Time Io ; O (4) Received by: Time (9) Relinquished by: Date Time ||(6) Received at Lab: M i CO CO

I—i Method of Delivery: UPS EC/EX PAS Courier Client US Mail Other

NYC-WTC_000222462