NYC-WTC_000227076

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order# Reading, PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page A of I fax: (610) 921-9667 or 921-8407 PO# Quote ft

Report Name TkGk'Wctyr CoV.v\ JOB iO: f3/JS-OJ3l Company Ato Results Mailing Address A. (oTv rf'too'n ANALYSIS REQUESTED To: City State ZIP /O0/£> Use attachments if necessary. Telephone# ,5 3 757. Please specify method requirements. Preservatives Key: Name A = Ascorbic Acid d Company Submit r C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice City Stale ZIP I - Ice Z = ZnAcetate To: Telephone # Fax# 4- N = NaOH X = None Credit Card Info (include exp. date)

R Sampled by; ^atfck' A '7~5rzV Sampling Location (Specify State):_________________ O = Other; Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) Reduced Deliverables Package Electronic Data Deliverables Preserv^es (See above Key; ' Full Data Package i list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) G^GIass. A=Air) % 2 SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info Container Volume (Liter, etc)

t (ID must match container labels) (L Dale Time Number of Containers Itl a^r- /Odo __ f-fk /b^or S) ^00 3i4r^- o3^3-K233-^S 10 3.0 1« tk /Loaf B

5 ' BliUuk 5

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s 9 lU o l°i (1) Relinquished by; Date Time (2) Received by: Dale Time 11(3) Relinquished by; -.Date Time o1 ■0 (4) Received by: Date Time (5) Relinquished by: Date Time |j(6) Received al Lab: Dale Time <01 rc O Method of Delivery: UPS PAS Courier Client US Mail Other Ca3

NYC-WTC_000227076