NYC-WTC_000224756

NYC 9/11 Public Portal Document

3 PSC Analytical Services T 4418 Pottsville Pike PSC Work Order# Reacting, PA 19605 CHAIN OF CUSTODY phone: (610) 921-8833 Page i of I c A fax: (610) 921-9667 or 921-8407 c PO# Quote # u Report Name ID: cr Company -a Results Mailing Address | (3 L/ g ,2S _ ANALYSIS REQUESTED To; Oily ylYe^ Slate /c'C'/c? Use attschments if necessary. ye^ephoneft^f^^ - ?5'j gSO£ Please specify method requiremenls. Preservatives Key: T If. Name A = Ascorbic Acid r. Submit Company c = Ha N2 = NaS2O3 Mailing Address H = HN03 S =112804 Invoice city Slate ZIP l = lce Z = ZnAcetate To; Telephone ft Fax# N = NaOH X = None Credit Card Info (include exp. date) Sampled by: Due Date: ~ az Sampling Location (Specify Slate):

REPORTING REQUIREMENTS (Circle all that apply) _______ (Rush TAT requires Lab approval) I O = Other:

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^PIaslic, G=Glass, A^Ait)

s SAMPLE DESCRIPTION Final Air Volume Sampling Info Container Volume (Lifer, etc) Matrix Type (ID must match container labels) (L or min) Date /^jiiiTimc Number of Containers cn I 1 UP o If CD (I 3 rc IS 4 c AO'S ~ I CD 5 cn o 6 cn -J K 7 I 8

so 9 I—i 10 o o I (1) Relinquished Time (2) Received by: Dale Time (3) Relinquished by: Dale Time o o ■a DO CO (4) Received by: 'Date Time (5) Relinquished by: Dale Time (6) Reel CO

O Method of Delivery: UPS FED-EX PAS Courier Client US Mail Other

NYC-WTC_000224756