NYC-WTC_000223160

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order# 7

r Reading, PA 19605 CHAIN OF CUSTODY t

phone; (610)921-8833 Page / of / C r fax: (610) 921-9667 or 921-8407 C POIt Quota# r Name ~ JOB ID: t Report t Company f"- T Results Mailing Address ANALYSIS REQUESTED To: /yy State zvy ZIP Use attachments if necessary. Telephone# ‘gr7'‘St7> Fax# 2^f — Please specify method requirements. Pfsservatives Key: b Name A = Ascorbic Acid f

Company 7 C =HCI N2 = NaS2O3 Submit Mailing Address ' 'I H = HNO3 S =H2SO4 Invoice City State ZIP 1 = Ice ;Z = ZnAcetale To: Telephone# Fax# N = NaOH X = None Credit Card Into (include exp. date) Sampled by: Sampling Location (Specify State): /VV 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=Blass, A=Air)

SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must inatcli container labels) (b-ef-iTTinh Date Number of Containers 0 1 / c

F £ <^rr)naSYu I a 3 / 0^1-0 1/ n 4 0 IT I (I Q 5 ^7.-' ZyYfY\^ 0

H 6 2 csi i £ 8 V

o 9 I—i o 10 o I o Dale Time Dale Time o (11 Relinquished by: i ■ Dale, Time (2) Received by. (3) Relinquished by. co to f/(/Y TC Tafe Date Time co (4) Received by: Time (5) Relinquished by Date Time n co; cn Method of Delivery; UPS (•'FED-EX.,.'' PAS Courier Client US Mail Other

NYC-WTC_000223160