NYC-WTC_000226823

NYC 9/11 Public Portal Document

phone: (610) 921-8833 fax: (610)921-9667 or 921-8407 O ro po# Quote It =z=^s= ~Q do N W JOB ID: ro Report Name Company KVc- MfdOLtufe XmC'. A) Results Mailing Address (u Li U ANALYSIS REQUESTED ■0 To: City State ZIP /£>&/£:> Use attacbments if necessary. Telephone #JLfJL. . <S Please specify method requirements. Preservatives Key: Name «a A = Ascorbic Acid TJ

Submit Company C = HCI N2 = NaS2O3 n Mailing Address H = HN03 S =H2SO4 Invoice city Stale □ ZIP I = Ice ;2 = ZnAcetate dj To: Telephone# Fax # V N = NaOH X = None u *1 Credit Card Info (include exp. date) X (+ Sampled by: Sampling Location (Specify Slate): J O = Other: _ 0 V 111 Due Date:_________________________ (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) 4 cn rs Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key, T list all that apply) < UST NPDES MIPP RCRA Storrmwater DEP (PWS # ) Type (P=Plastic, G-QIass, A^Air) n to 3 SAMPLE DESCRIPTION Final Air Volurat Matrix Type Sampling Info Container Volume (Liter, etc) w H (ID tniisi match container labels) (L jBBiin) Date Number of Containers Time 1 4rC" M-SQ - ( aiV tn 2 ,4rc> Odd(- /Mg4 - □ 3 4re- dStdt- /do UJ w 4 ficTre- ~ /do /Lag CD 5 Ale- 3 ia r<-A r m 6 m Q H K 8 I EO 9 S O Lil o o (1) Relinquished by: ------- Dais Time (2) Received by Date I ime (3) Relinquished by: Date I ime I o o (4) Received by: Ua'e I ime Date iine EO Time (5) Relinquislieo by Date (6) Received at Lab. OS’! T3 EO ro CO Mpiiiii (•’! Dch ITS y^TD EX J PAS Coiirie' Clicpl i IS Mai! other CO CO

NYC-WTC_000226823