NYC-WTC_000223153

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike PSC Work Order » Reading, PA 19605 CHAIN OF CUSTODY phone: (6iu) 521-8653 Page Of t fax: (610) 921-9667 or 921-8407________________ PO# Quota # =^=====x=K====xs==:=x=: Report Name ( pV'A------------------ ID; S' - Company Results Mailing Address C) foTL ANALYSIS REQUESTED To; City Z/gxzU state ZIP Use altachments it necessary. Telephone# jg <7. g 2^0 Please specify method requirements. Preservatives Key; Name A = Ascorbic Acid I I Submit Company C = HCI N2 = N3S2O3 Mailing Address Os H = HN03 S =H2SO4 Invoice City To; Telephone# Credit Card Info (include exp. date) State Fax # ZIP

4 l = lce N = NaOH Z = ZnAcetate X = None

I sax SampiedTyi__^_____________ 0 = Other Due Date: (Rush TAT requires Lab approval)

I REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; rrst all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic. G=Glass, A^Air) » SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L [III nm) Dale Time Number of Containers

4/^/L. At‘>a (/ Er 4I> y ( 2< 4Tc - -m t 22 0 -J.] ina (f ( I 4* /Jeo Sao 5 > /^jeu^K ( a : 6 ( t H

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I o 9 10 o I (1) Relinquished by^.--—^ Dale Time (2) Received by; Dale Time (3) Relinquistied by: Date Time o o to 4^/ co (4) Received by Dale Time (5) Relinquished by: Dale Time {6) Received at Lab: i Date Time co i^Mi dt. co o FED-EX PAS Courier Client cn Method of Delivery: UPS US Mail Other

NYC-WTC_000223153