NYC-WTC_000223155

NYC 9/11 Public Portal Document PSC Analytical Services 4418 Pottsville Pike PSC Work Order # c Reading, PA 19605 CHAIN OF CUSTODY c □ phone; (610) 921-8833 Page T Of A faxJ610)221-96672r921-8^ PO# Quote # c a f /a U.t/\____________________________________ Report Name Company -^goOuaJt^ Xv<L._______________ zs— 'D- c -» Results Mailing Address jc/1^ fTv~ AWALYS/S REQUESTED u u To: State x/Z ZIP Use attachments if necessary. ■0

Telephone#^ t ^-80 3^3. 8?c Please specify mathoC requirements. Preservatives Key: Name A = Ascorbic Acid

Submit Company Mailing Address 52?^ C = HCI H = HN03 N2 = NaS2O3 S =H2SO4 Invoice city To: Telephone# State Fax# ZIP 1 I = Ice N = NaOH Z = ZnAcetate X = None Credit Card Info (include exp. dale) Sampled by. z, Sampling Location (Specify State): O = Other: —— Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Da’a Package Reducer* Deliverables Package Electronic Data Deliverables Rnawn«th«s (See above Key: 9. ___________ UST NPDES MIPP RCRA Stormwater DEP (PWS# I r^tP-flaslK. G’^GIess. A*Alr)

S SAMPLE DESCRIPTION Final Air Volumr Matrix Type Sampling Info 9^^ 9^^ p>w 9^H94 Container Voluma (Liter, etc) g (ID must match container labels) (L Miiirrhi) Date Time 1 » SZSZESSHzmx /J 0] t—

□ 4 /I z I cc 5 7 ri3 I 6 u m o m H s 9 to S o (2) Received by: Date Time o o (1) Relinquished by: Dale Time T[3) Relinquished Oy: Dale Time

I o o CO (4) Received by: Date Time (5) Relinquished by: Date Time f(6) Received at Lab: / S?*® Time "'A'® TJ

CO Methoij of Delivery: UPS ED-EX PAS Courier Client US Mail Other co co

NYC-WTC_000223155