NYC-WTC_000223511

NYC 9/11 Public Portal Document

• 'Y'- *!< FSC _____________________ 4418 Pottsville Pike Chain of Custody Record Reading; PA 19605 Bottle Type ZT Samp/e Container information a m n w ( G P IH I *—/ 0} ■ ^::^^^mISXlSRVK;E£^^ # of Containers 1^ a

Zl_- Nama —--I--— Preserved? (Y/N) o Report ro Results Mailing Addrese^^^g^^^ 0) To: /orA Name Telephone # ■« s !

Dept. Send Invoice Mailing Addtess /Loiiwn^- I To: Citv State ZIP '^Page s H- Credit Card S Exp. Date PAS Quote// 2 Sampled by: Air Vol (L Mafriit Date Time or min) Type Sampled .Sampled tn SAMPLE DESCRIPTION yL Commcnts/Hazards/ Location Details (D MlHti- T I 1 aif C 0 2 US ID 3 -HjaAAreq____________ W 4 kTc 0 Axova J/ 5 ^3f FrovV tn 6 Frd^vY-t CourtotA^tEcAtorr □ CD ?i«C,K yet-rc^ cjcsKtLcoa 7 111 ro 8 to tn 9 I' V tn 10 o H Spi(edal Instructions (including Data Dc^era^s and Tuni H hC I Samples relinquished to Samples Rcllnquisheil by: J Samples Relinquished to: j Date j Time to ■ shipper or courier bv: Samples received by: Date I Time Samples Relinquished by: . Samples Relinquished , Dale Z , Time , I' Method of Shipnient/Deiivcry: UPS / FED-EX^PAS Couner *»>> I Client drop off Other 1 Laboratorv:

"0 o Samples Rec'd..on Ice? | Y N d^aJ ~~ Temp. Blank Sample Temp. Notes : I ! Samples rac'd intact/Si'l I Custody seals intact?) Y N icTon samples match C0C?GiJ^ ) co VOC Samples have zero headspace?) Y N Samples properly preserved? I Y N CO

NYC-WTC_000223511