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NYC-WTC_000223524

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000223524
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Scanned page image, NYC-WTC_000223524
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NYC 9/11 Public Portal Document

-n Chain of Custody Record Sample Container Information m tr 4418 Pottsville Pike Reading, PA 19605 Bottle Type o tTtr-jgElffnrjmK phone; (610) 921-8833 fax; (610) 921-9667 I R p IH 1 ’—7 ANALYTICAL SERVICES □ # of Containers |po # w Preserved? |Y/N) CZ^ Nama “I Report company C^A\y\ O

X^c U w Results Mailing Address g, gU (II To:

T3 tn Name Telephone # n n Send Company Dept.

Invoice Mailing Address

To: City State ZIP ymioisffo age L of/ u 3 Ol t-*

ft H- Credit Card # Exp, Date 0 PAS Quote# 01

Sampled by: AirVoi.(L Matrix Dale Time 0) SAMPLE DESCRIPTION Type Sampled •Sampled ■Y^omments/Hazards/ Location Details m zn/Afg T I 1 4-Te , IM. Ar //m/p2 n 2 "^^^Z^^^^^ZZZZZZZZZZZ 4 i lr (B 14

5 m 6 a CD 7 ro 8 CD m 9 CD

10 o Special Instructions (including Data Deliverables and Turn Around Time): H kJ

L Date Time Samples Relinquished by; I Samples Relinquished to; I Dale I Time r \iMd^ ' Samples received by; ' ~ Date I Time Samples Relinquished by; , Samples Relinquished to , Date Time o I Laboratory: II 9'</5' o Method of shipmentZDeiiv'ery: UPS PA^ (jouner (Client drop off Other -D o ro Samples Rec'd. on Ice? ( Y iNAn/a) Temp. Blank Sample Temp. —■ Notes ; co Samples rec'd intactr^N ) Cu^dy seals intact?( Y N ) ID on samples match C0C?(S)^ ) o co VQC Samples have zero headspace?) Y N .i@l Samples properly preserved? ( Y N ,4^)

NYC-WTC_000223524

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NYC-WTC_000223524Source: NYC Law Department, mirrored locally

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NYC-WTC_000177925

Form recording the chain of custody for samples submitted to Analytical Services in Reading, Pennsylvania.

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