NYC-WTC_000223154

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike PSC Work^^er # 3 T3 1

Reading, PA 19605 CHAIN OF CUSTODY n 0 phone: (610) 921-8833 Page ( of j fax: (610) 921-9667 or 921-8407 n PO » Quote # c n I Name Report Company CoXa SCccJcJET JOB ID: /Y/,3 A-QA-7? U Results Mailing Address tO U ANALYSIS REQUESTED TJ

To: City state ZIP /Oo/c? Uss attachments if necessary. Telephone#9(dO<r Please specify method requirements. Preservatives Key: t Name u A = Ascorbic Acid r Submit Company C = HCI N2 = NaS2O3

J Mailing Address H = HNO3 S = H2SO4 Invoice city state ZIP l = lce Z = ZnAcetate To; Telephone # Faxff N = NaOH X = None Credit Card Into (include exp, date)

Sampled by: Sampling Location (Specify State); O = Other: Due Date; (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; " list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G=G(ass, A=^Airj

1 i SAMPLE DESCRIPTION (ID must match container labels) Final Air Volume

(L-os-hhiA Matrix Type

Oi'K Date Sampling Info

Time Container Volume (Liter, etc)

Number of Containers tr 2 / J-O Xo g c I 3 / ji6 So t£ PC 4 I2O Socj I 5 (’ (£ CT 6 CT n A 7 A I 8 to 9 g o 10

o Date Time (2) Received by: Dale Time I (1) Relinquished by: (3) Relinquished by: Date T ime o o "0 (4) Received by: Dale Time (5) Relinquished by: Dale Time (5) Received at Lab. Dale Time CO CT CO LO 'iT-ci I PCO I (-O Method of Delivery; UPS D- PAS Courier Client US Mail Other

NYC-WTC_000223154