NYC-WTC_000226970

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order If

Reading, PA 19605 CHAIN OF CUSTODY 02 OIOSS’S’ S ' phone;(610) 921-8833 Page o. ro fax; (610) 921-9667 or 921-8407 PO# Quote #

Report Name C 'OXAVV_________ . JOB ID. |.QIAg-oA4-4 Results Mailing AddressA-rc ’^10 CCciK' Juc, lO 'lL' Company ANALYSIS REQUESTED T To: City yg A State ZIP /cifOf'O Use attachments if necessaiy. Telephone » J. ~ 3 S'J ■ S T-’g O Fax# Please specify method requirements. Preservatives Key: T] Name tn A = Ascorbic Acid n Company C = HCI N2 = NaS2O3 Submit D Malling Address H = HNO3 S =H2SO4 □ Invoice city iState ZIP l = lce Z = ZnAcetate 01

To; Telephone ft Fax# .s) u N = NaOH X = None ft Credit Card Info (include exp. date) 0 Sampled by: '~p<4z.-2-rX Sampling Location (Specify State): yV- y______ 0 = Other; 0) Due Date: U (Rush TAT requires Lab approval) tn REPORTING REQUIREMENTS (Circle all that apply) (D .7 Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key: * c list all that apply) 0 UST NPDES MiPP RCRA Stormwater DEP (PWS# ) Type (P-Plastic, G-Glass, A-Air) IB W % 2 SAMPLE DESCRIPTION Final Air Volumf Matrix Type Sampling Info Container Volume (Liter, etc) (ID must match container labels) Date Time Number of Containers Ui'k' T//U6^ tn / If'Lf 6 O □ 2 (tiohtT tfl 3 ID 4 tfl tn 5 tn 6

7 n S 9 10 n (1) Relinquished by; — Dale lime 2) Received by. Date lime (3) Relinquished by: Date Time TJ (4) Received by: Date Time (5) Relinquished by: Date Time (6) Received at Lab: Date Time ro Method of Delivery; UPS ED-EX PAS Courier Client US Mail Other (_n

NYC-WTC_000226970