NYC-WTC_000226966

NYC 9/11 Public Portal Document

FSIZ PSC Analytical Services 4418 Pottsville Pike PSC Work Order# 35 ■D 3 a Reading. PA 19605 CHAIN OF CUSTODY ro a phone: (610) 921-8833 Page 1 of —I ro fax: (610) 921-9667 or 921-8407_______________ a PO# Quota X -h

Report Name CJci ku JOB ID: a 05 Company AffoccotLc^ Ty-C- T5 Results Mailing Address (O Lf- ANALYSIS REQUESTED To: City Zo S^te Use aftactmenfs if necessary. Telephone - g O Fax#4 Please specify method requiremenls. Preservatives Key: (_i Name A = Ascorbic Acrf 0) 3 Company n> Submit C = TCI N2 = NaS2O3 u» Mailing Address H = HNO3 S =H2SO4 Invoice City State ZIP I = Ice Z = ZnAcetale u Ql To: Telephone U Fax# N = MaOH X = None O TT Credit Card Info (include exp. dale) .11-- ■:

1 Sampled,by: Sampling Location (Specify Stale): ZY^ O = Other; 3 Due Date; _______________________________ (Rust TAT requires Lab approval) REPORTIMG REQUIREMENTS (C rcte all that apply) ' Full Data Package Reduced Deliverables Package Electronic Da;a Deliverables PiBss/vafivss [Seo above Key; Ssl all Ihai gppty) UST NPDES MIPP RCRA Stormv/ater DEP (PWS# 1 Type (P=Piastic G=Giass, A=AirJ at 2 SAMPLE DESCRIPTION Final Air Volunit Matrix Type Satnpkng Info Container Volime (L8er, stc)

6 (ID mustmaiti container labels) (Lj2I3Bt3J) Date Time Number of Containers

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n 7 8 9 s 10 p (1) Relinquished by: Time {2} Received by: Date T me (3i Relinquished by: Date Time o 1 o TJ o (4) Received by: ' Date Time. (5) Relinquished by: Date Tme (6j Received al Lab: Time o cn kjD

Method of Delivery: UPS ED-EX PAS Courier Client US Mail Other to

NYC-WTC_000226966