NYC-WTC_000224748

NYC 9/11 Public Portal Document

F=SC PSC Analytical Services 4418 Pottsville Pike PSC Work Order it Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page / of / fax: (610) 921-9667 or 921-8407 PO# Quote It

Report Name JOB ID; Company Results Mailing Address ANALYSIS REQUESTED To: ciiy Slate /V V ZIP Use attachments if necessary. Telephone # 71 V- T- — " Vs-' 6 Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid ( Company Submit C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 Invoice City Slate ZIP I - Ice Z = ZnAcetale To: f' Telephone# Fax# N = NaOH X = None Credit Card Info (include exp dale)

Sampled by: / sT^Z.'Z-’-c^ Sampling Location (Specify Stale): /V 7 d O = other: Due Date: / (Rush TAT requires Lab approval) oil +hol In all REPORTING REQUIREMENTS (Circle that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; list all that apply! UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P=Plastic, G=G/ass, A=Air!

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

(ID must match cniilaiiicr labels) (L or tnift) Date Number of Containers t 1 •- <liSlo2 —4^ A^ri/>Cr »S2 t - 400 ( 3. lyC/1-/ro/y) - i/7 C 7, bC'U r ■ 7 Arc-o$IT>-/TirO-)- t c 6 c n H l"^ S to 0 Q to o 1^ (I) Relinquished Dale Time (2) Received by: Dale Time (3) Relinguished by: Date Time o t NO (4) Received by: Dale Time (5) Relinquished by: Date Time (6) Received at Lab: Sf. . . Dale Time CO p.ndX- /6rHw\ Cn Method of Delivery: UPS ED-E^Y PAS Courier Client US Mail Other Cn

NYC-WTC_000224748