NYC-WTC_000223189

NYC 9/11 Public Portal Document

CD RSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order # 0. Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page 1- of 4 fax: (610) 921-9667 or 921-8407 PO# Quote# JOB ID: Report Name it Company Xvvc Results Mailing Address ANALYSIS REQUESTED (D jOLf (0 n To: state 7^/ ZIP Use attachments if necessary. al Please specify method requirements. Tetephone*^ IX. 0 Preservatives Key; PJ Name A « Ascorbic Acid m r I □ Submit Company S2 C = HCI N2 = NaS2O3 Mailing Address

J H = HNO3 S = H2SO4 CD Invoice City State ZIP I = lce Z = ZnAcetate To: Telephone # Fax# N = NaOH X = None Credit Card Info (include exp. date) J

I SSSaSSS5aSBBBBHHBBHBSBBSBa=S=SSSSS=SSaSBS=a Sampled by; Sampling Location (Specify State); 0 = 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=Plasbc, S=Glass, A=Air)

s SAMPLE DESCRIPTION Final Air Volumi Matrix Type Sampling Info Container Volume (Uter, etc)

(ID must match container labels) (L lifc-mm) Date Time Number of Containers

1j - jS'g ( - V 7f^ 5/0 l-olgUt^ 2 4 u CD u ci

0. 4«.4T'c- A o 5 I—I H 6 K 0. I CD 7 FO 8 S O 9 o lO w □ Date Time (1) Relinquished by: Time (2) Received by; (3) Relinquished by: Date Time FO ■r CO CO (4) Received by: Date Time (5) Relinquished by: Date Time (6) Received al Lab. "y Oh to co z 31 re PAS Courier US Mail ----Other WvT Method of Delivery: UPS FED-EX Client

NYC-WTC_000223189