NYC-WTC_000223199

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike - PSC Work Order# c

Reading, PA 19605 CHAIN OF CUSTODY c a phone: (610) 921-8833 Page j of fax; (610)921-9667 or 921-8407 c fl po# Quote # c Name JOB ID: -» Report I Company ___ u Results MaiCng Address ANALYSIS REQUESTED TJ O’

To: City /VV Slate //V ?IP Use attachments if necessary. Telephone# - Please specify method requiremenis. Preservatives Key:

I Name A = Ascorbic Acid

Submit Company C = HCI N2 = NaS2O3 Mailing Address Invoice ci^ state ZIP § H = HNO3 S = H2SO4 l = lce 2 = ZnAcetate To: Telephone# Fax# N = NaOH X = None Credit Card Info (inctude exp. dale) asssssassssasBB Sampled by: Sampling Location (Specif State): /y _____ 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 ail that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G=Glass, A-Ah)

2 SAMPLE DESCRIPTION Final Air Volumi Matrix Type Sampling Info Container Volume (Uler, etc) Fl tlD must maicli cuiiuuiia iubcU) (L-er-snin^ Dale r'lwTimc Number of Containers I ___ . CT I 2 Iz’* I .1 1 tx ( 4 s’’/? - ' T* A

5 I/'' u I

o 6 IT I—I H cr 7 8 s Q 9 I—i o 10 o I o (1) Relinquished by: Time ;2) Received by: Date Time (3) Relinquished by: Dale Time o CO CO LO (4) Received by: <Ss Time (5) Relinquished by. Dale Time (6) Received at l ab: /O '^Vz' A- Dale Ai T irnu "0 Pl cn Method of Delivery: UPS ^ED-EXPAS Courier Client US Mail Other

NYC-WTC_000223199