NYC-WTC_000224779

NYC 9/11 Public Portal Document

ssc PSC Analytical Services 4418 Pottsville Pike Reading, PA 19605 CHAIN OF CUSTODY PSC IWork Order* c c

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phone: (610) 921-8833 Page of c fax: (610) 921-9667 or 921-8407 n PO# Quote # c 0 Report Name JOB ID: Company u b Results Mailing Address ANALYSIS REQUESTED ai To: City /VV/ state /Y U'/ ZIP Use attachments if necessary. Telephone # 2 ~T Please specify method requirements. Preservatives Key: 1 Name A = Ascorbic Acid u Company r Submit C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice City state ZIP l = lce Z = ZnAcetate To: Telephone # Fax ff N = NaOH X = None Credit Card Info (include exp. date) Sampled by: y Sampling Location (Specify State): /\f^l 0 = Other: Due Date: 7 (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) j Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservathras (See above Key; list all mat apply) UST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=PlaHic, 6=Gless, A^Air)

I SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info Container Volurrte (Liter, etc). (ID must match container labels) (L-es-awiy' Dale Time Numbero! Containers « I [J 2 c I 3 u A 4 I 5 u 6 a Q I—I a H 7 l"^ 8 I—i 9 s Q I—i IO o o Date 1^ Time (2) Received by: Time (3) Relinquished by: Date Time o -Q (4) Received by: Date Time (5) Relinquished by: Date Time (6) Received at Lab: CO

(_7l Method of Delivery; UPS PAS Courier Client US Mail Other

NYC-WTC_000224779