NYC-WTC_000223619

NYC 9/11 Public Portal Document

PSC Analytical Services 4418 Pottsville Pike PSC Work Order # •X Reading, PA 19605 CHAIN OF CUSTODY c phone;(610) 921-8833 Page ( of I. fax: (610) 921-9667 or 921-8407 c PQif Quote# h

Name <3p^ JOB ID: |‘n^-CZ3&‘=( c Report Company jV\r- -M/a Ct ofo, T V<C____________ Results Mailing Address yp Q ig, ANALYSIS REQUESTED c -I To: Slate zAr/__________ ZIP /OO/O Use attachments if necessary. •x Telephone. 8 I. < o Fax# .&7d 6 Please specity malhad requiremems. Preservaiivcs Key: Name A = Ascorhin Acid 1 Company I C-HC! a Submit N2 = NaS2O3 r Mailing Address H = HNO3 S = H2SO4 Invoice ciiy Slate ZIP i = Ice Z = ZnAcelalp To: Telephone# Fax # N = NaOH X = None Credit Card Info (include exp. date) ^Sssssss=ss=ss!sssss=s:±ss=sssssssss=s=sss:s:ssz. Sampled by: nSampling Locatior. (Spscify Stale): O = Other.

Due Date; (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package - Reduced beiiverablos Package Etectronk: Data Deliverables PrBSBivyilhiss (See above Key; I list a!/ that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ] Type (P=Plastic. G^GIass. A=fijr) % SAMPLE DESCRIPTION ! Kn»I Air Volumi Sampling Info Cc.otainar Volomc (Liter, etc) 2 e (ID must match container labels) (I- or mill) Matrix Type Dale • Time Number of Containers

r*- 1 O-t'r Ltil^ lll(iJ^AMrfae£c 0 <( 7 #7-c-oiJJ^ - /yo 6o'^ L J Ta Ze> a c I •1 o efaery ^o3 a n a tZ 1 6 U o O' 7 ff H s to 9 I—i S 10 a I—i o (2) Received by; □ate Time o (1) Relinquished by; , Time (3) Relinquished by; Dale Timo I o __________ 2^^ ________ X? o (4) Received by: Dale Time (5) Relinquished by; Dale Ttma ’(6)Rece^atLa^ / 7 Date Tune "B I—i i\ Method of Delivery; UPS ED-EX PAS Courier Client us Mail Other ■ ' a CO

NYC-WTC_000223619