NYC-WTC_000226948

NYC 9/11 Public Portal Document

i a n» Chain of Custody Record Sample Container Information 0

ANALYTldAL SERVICES 4418 Pottsville Pike Reading, PA 19605 phone: (6101 921-8833 fax; (610) 921-9667 Bottle Type 1 G P IH ) # of Containers ^/i| I l I I I IT ' W

□ |PO < Preserved? (Y/N) □ Name tn Report company 7Y /Y Co ______ ■tk UI Results Mailing Address /OZf ’ &i

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n H Samples Relinquished by; Samples Relinquished (o; I Dale I Time LO I n Samples received by: ' Date Time Samples Relinquished by: o I o Method of shipment/Delivery; UPS LH^-tiX Y PAS Couner Client dropoff Other o ro o Samples Rec’d. on Ice? ( Y rftp'n/^ Temp. Blank Sample Temp.______ ■ Notes : Samples rec’d intacl2£^ ) Custody!seals Y N^waj) ID on samples match COCg^V^ ) VOC Samples have zero headspace?! Y n/^J Samples properly preserved? | Y N^rlVaZZ

NYC-WTC_000226948