NYC-WTC_000223204

NYC 9/11 Public Portal Document

CD RSC PSC Analytical Services 4418 Pottsville Pike _ PSC Work Order # B. Reading, PA 19605 CHAIN OF CUSTODY phone; (610) 921-8833 Page \ of j fax; (610) 921-9667 or 921-8407 PO# Quote#

^OLnAy<ax> CoVsw JOB ID: Oof L Report Name Company Txc Results Mailing Address lQ(, ANALYSIS REQUESTED co co To; City yo I'A, Slate US6 attachments if necessary. cn I Telephone# ^<7, ^2,'lzj Please speetty method requirements. Preservatives Key: w Name A = Ascorbic Acid m I Submit Company 0 C = HCI N2 = NaS2O3 □ Mailing Address H = HNO3 S =H2SO4 co Invoice Oty Slate ZIP l = ice Z = ZnAcetate To: Tetephono# Fax# N = NaOH X = None

Sampled by: Due Date. Credit Card Info (include exp. date) Sampling Location (Specify State): (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all thafapply) I O = Other:

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=Glass. A=Air)

SAMPLE DESCRIPTION Final Air Volumi Matrix Type Sampling Info Container Volume (Liter, etc) 1 (ID must match container labels) (L tfl-WWlt) Date Time Number of Containers tki'r os-c f- jt/- m z. u co 0. I - /TY - ____________ A Jt Q 6 H B. l"^ w cn R I—i s 2! s 10 i o w I o (1) Relinquished by: Pale Time (2) Received by: Date Time (3) Relinquished by: Dote Time o o in CO (4) Received by: Dale Time (5) Relinquished by: Date Time (6) Received at LaLr>^____ _ CO

CTt n r . -... -XMT o Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other

NYC-WTC_000223204