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NYC-WTC_000226962

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000226962
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NYC 9/11 Public Portal Document

-n Chain of Custody Record Sample Container Information ft) tr 4418 Pottsville Pike Reading, PA 19605 Bottle Type o phone: (610) 921-8833 fax: (610) 921-9667 I G P IH 1 tn ANALYTICAL SERVICES of Containers 1^ o |po # ro J**"’ VM Preserved? (Y/N) (=> -Sa-yv<&o CoVAvy ________________ □ ro Report Ar-vc AsiocCojte ui Results Mailing Address tU lO^ ^■ CD TJ To:

tj tn Name Telephone 9 n Send ^'’Tnpany Dept. 3 □ Invoice Address (U I (£ To: Citv State ZIP y^Page \ of i ri H' Credit Card # Exp. Dale PAS Quote# 0 0) Sampled by: /y Air Vol. (L Matrix Date Time Type Sampled Sampled tn I SAMPLE DESCRIPTION orntln) // Comments/Hazards/Location Details (D T »l^rc-ol3d -?T/. C

If 2 __ kVg n m (f 3 <- ___ in

al y Tc.-dQi-. X7y fl^ir 5 '

5 m »-* 6 □ 7 ui ru 8 (D tn 9 tn a 10 H K Special Instructions (including Data Deliverables and Turn Around Time): I N) ,

S' o Samples relinquished Io Samples Relinquished by: I Samples Relinquished to: Date j Time shipper or courier by: o Samples received by: Date I Time Samples Relinquished by: Samples RelinoHfs^d to / - / .Date Ti^ o I o I Laboratory: O ' Method of Shipraent/Delivery: UPS FED-EX PAS Courier Client, dropott Other TJ CO Samples Rec'd. on Ice? ( Y Nfto/ap' Temp. Blank.__ Sample Temp. Noles : UI co Samples rec'd intaqt^^N ) Custody seals intact?! Y iSon samples match COC^f>fJ ) o VOC Samples have zero headspace?! Y NCY/aJ Samples properly preserved? ( Y N

NYC-WTC_000226962

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NYC-WTC_000226962Source: NYC Law Department, mirrored locally

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Form recording the chain of custody for samples submitted to Analytical Services in Reading, Pennsylvania.

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