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NYC-WTC_000226990

Label derived from the City's folder field. The City does not supply document titles.NYC-WTC_000226990–000226991
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Scanned page image, NYC-WTC_000226990
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NYC 9/11 Public Portal Document

PJ Chain of Custody Record Sample Container Information , 0. BSE^saKaaQKaHBBntKsiiBM . ANALYTICAL .SERVICES 4419 Pottsville Pike Reading, PA 19605 phone: (610) 921-8833 fax: (610) 921-9667 Bottle! ype P—T 1 G P IH 1 # of Containers i^ r ri' I'( rrrm jpow Preserved? (Y/N) C2> Name Report Results r- To: CD CD OT Telephone Fax 1/j; . .g ; r-i PJ Name Telephone # 07 —~r-r9- O Dept, to Send InVOiCB V'a'''r>0 Address

To: City State ZIP MPage £ of M w Ctedil Card Exp. Date PAS Quote# w u •rt ! > Sampled by: vJ Air Vol (L Mnirit Dale Time L SAMPLE DESCRIPTION artnin) Type Sampled Sampled dJ lomments/Hazards/ Location Details to 1 Aic-oi&k- s>y - S- 2ib TWei aiCkhoci CiV"________ ______ fl, O 2 /iTc-- ofeir- STy> 11 _J_ •/ Mft-uU. {^u.'tvLb.v4:<.

•rt P i 3 <3icq - yry • -y 3 Ml if'2 O 37 r-< 4 /ru-ei£H-532Lla_ Ml IM c fl) 5 -c-jcu - Ml Ml / /-let- : cE 6 ^tlrc-efci/ - gu- __ _M1 u 7 /VTc-CiCir - yr7~ j’ q gii ^•rJ. l/tcvT w a. 8 Arc-’.v i*. z 2 Q 9 /;rc- 6^icv-,yTy-,$7 £11 Acr -« /J

I H K D. r 10 /a. - ci PY- Lit /ifio.M s’t. fJer'fU Special Instructions (including Data Deliverables and Turn Around Time);

I □ o .■n Samples Relinquished by: I Samples Relinquished to: I Date I Time o ,M I o □ • Samples received by: Date Time Samples Relinquished by: . Samples Relinqui^d to y .Date Time o 13 1 Labaratnrv':/%t*3V^ y y o'x-J-e 7/,^ CO Method of shipment/Deiivery: LIPS Q RTD-£X- Pa5 Couricr Client dfop off Other cn c p,». Sarn^g f^^ 'opjee? ( Y Nrlj^ Temp. Blank Sample Temp. _ Notes: n n Samples rec'd intactm^N ) Custody seal^ntact?! Y ID on samples match CQC^V^N > j VOC Samples have zero lieadspace?( YtS-p/^ I Samples properly.preserved? I Y.N.f^7a>i

NYC-WTC_000226990

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NYC-WTC_000226990Source: 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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