NYC-WTC_000226974

NYC 9/11 Public Portal Document

PSC Analytical Services Z 01 . 4418 Pottsville Pike PSC Work Order #

S Reading, PA 19605 CHAIN OF CUSTODY L (lo Page ~('~T~rsr~' 73 I * 4) w CD phone: (610)921-8833 Psq a fax: (610) 921-9667 or 921-8407 ru POtt . Quote» . O 0) Report Name JOB ID: Id Results Mailing Addresr (U ANALYSIS REQUESTED ED To; city /\JUl : Stale /yt/ ~~ Use attachments if necessary. ■ 'O'-

Telephone# 12 ~ Please specif/method reqi/irements. Preservatives Key: Name fi = Ascorbic Acid Company C = HCI IN2 = NaS2O3 Submit Mailing Address H = HN03 S =H2SO4 Invoice city Stale ZIP o I = Ice <Z = ZnAcelaie To: Telephone # Fax # N = NaOH X = None Credit Card Into (include exp. dale)

0 “ Other: Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Full Data Package Reduced Deliverables Package Electronic Data Deliverables ;{ ----- Presenatives (See above Key: list an that apply) UST NPDES MIPP RCRA Stormwater - DEP (PWS # I Type (P=Plastic. G-GidSS, A^Ajl)

2 SAMPLE DESCRIPTION Final Air Volumr Matrix Type Sampling Info Container Volume (Liter, etc) in (ID must match container labels) (I. .Qt-miw)- Dale - ^inie Number ol Containers I 2 7^^ 3/w2i v/ 3

4

5 6

7 R 9 to

{1) Relinquished by: Dale Time -Jl{2) Received by; Date Time I|(3) Relinquished by: Dale Tune Q ■ yh//^ 2^ ' OMe 11(61 Received at Lab: TJ (4) Received by; Time 1(5) Relinquished by: Dale Time 'O»: Dale Time

I K 0 0.3 5JC.. Id ru /FED-EX...-^ PAS Courier- Client Method of Delivery: UPS US Mail Other o O o I o o CO

03 CO

NYC-WTC_000226974