NYC-WTC_000223214

NYC 9/11 Public Portal Document

RSC PSC Analytical Services 4418 Pottsville Pike PSeWork Order# ( Reading, PA 19605 CHAIN OF CUSTODY phone: (610) 921-8833 Page Ot -t fax: (610) 921-9667 or 921-8407________________ PO# Quote* I ssss===: I Report Name JOB ID: i Company Arc. £wc I Results Mailing Address ANALYSIS REQUESTED To: C«y /VfefaZ State ZIP Use attachments if necessary. Telephone 3^3. Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid ( Company •5k ( Submit C = HCI N2 = NaS2O3 Mailing Address 0 H = HN03 S =H2SO4 Invoice city state ZIP I = Ice Z = ZnAcetate To: Telephone # Fax# N = NaOH X = None Credit Card Info (indude exp. dale)

Sampled by: Sampling Location (Specify State): O = Other; Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced DeSverables Package Electronic Data Deliverables Preservatives (See above Key: list all that apply) UST NPOES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic, G=Slass, A=^Air)

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

(ID must match container labels) (I, er win) Date I Time Number of Containers

1 di <1/'K ^^'vr if c 2 ^2- / c

Q 3 4 5 STY- 1 J- * 6 I bVvA itis^ _____________ t r

t 6 Q H 0 T 8 S o 9 I—i o 10 o I o Time (2) Received by; Dale Time j|(3) Relinquished by; o (1) Relinquished Date Dale lime CO CO (4) Received by; Date Time (5) Relinquished by Dale Time (6) Received at Lab; Date Time 7 y-UtiCTir V Jo VZ »O co c (JI Method of Delivery; UPS PAS Courier Client US Mail Other

NYC-WTC_000223214