NYC-WTC_000223513

NYC 9/11 Public Portal Document

a Chain of Custody Record Sample Container information ID 0 4418 Pottsville Pike Reading, PA 19605 ““ Bottle Type ZZT B-v-.-3'_’akjes.K-’ai-.=c.'2s4L n*.j#t.sT^Tifc-.-^. j phone: 1610) 921-8833 fax; (6101 921-9667 t G P IH I tD ANALYTICAL SERVICES # of Containers Q |PO # Job ID Preserved? (Y/N) D Name '~\ooN<ez^ Cb K\\ Ji

Report Company a Results Mailing Address o g hr^ (OlkjU ■D

To; ybfk SW, ZIP ■Q tn Name Telephone i n,

Send eowpany Dept. □ 01 Invoice Address V^'»r r-' (Jl To: City State ZIP ZjPage I f+ H- Credit Card # Exp. Date 0 PAS Quote# ft)

Sampled by:__________ Air Vol. (L Matrix Dale Time or mln) Type Sampled Sainpird tn SAMPLE DESCRIPTION Comnienls/HazardsZ Location Details ID T I 7^ ai>< 7/6 < H-

I 2 /lrc> 3 A-rcL^(^4-jL32f^Pcs m. 0 ID W llhl Ao? 4 4-Tc-|Xo6-13^M- 110,0 66 0 1/ figoiK ___________ F'faAA' gnlYtAtACx cyaJis>i.O)ort I CD w 6 4r«^ - l^b -13 M ~ 7/ 7 Froixt Qo (-<ri cfvJr<koorj □ U) Q>b’rty<x rt/ g i^djaars ro I-* 8 Jlrtfik A*r ?KtoX U) 0) 9 1.^6 ~JIS 0)

10 Q H ' Special Instruclions {including Data Deliverables and Turn Around Time):

_______ z/ job Samples relinquished Io __ ’ > , Date Time Sainiiles Relinquished by: Samples Relinquished to; Date । Time SQ I shipper or courier bv: |/^/o7 I o ) Samples received by; I Date I Time Semples Relinquished by: Samples Relinquished to 75 i /, Time o I Laboratory; Z J I o o Method of Shipment/Dclivery; UPS gaaq PAS Courier Client drop off Other tJ Samples Rec'd. oQlce? I Y NQt^ Temp. Blank _____ Sample Temp._______ Notes: CO Samples, rec'd intactZS>W ) Custody seals intact?! Y N ID on samples match CO^ D o co Ol VOC Samples have zero headspace?! Y Samples properly preserved? ( Y CT)

NYC-WTC_000223513