NYC-WTC_000229421

NYC 9/11 Public Portal Document

GJ RSC PSC Analytical Services 4418 Pottsville Pike <—>) PSC Woric Order # Q. Reading. PA 19605 phone: (610) 921-8833 CHAIN OF CUSTODY Page i of ( fax: (610)921-9667 or 921-8407 PO#______ Quote # Name James Cohn JOB ID: 19125- 67/4 Company ATC Associates Inc. Results Mailing Address 104 S Street ANALYSIS REQUESTED CO U3 tn To: city ny“ State NY_______ Z'P 10010 Use attachments if necessary. I Please specify method requirements. Telephone# (212) 353 8280 Fax# (212) 353 8306 Preservatives Key; GJ Name A = Ascorbic Acid 0) I Company □ Submit SAME C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S =H2SO4 CO Invoice city state ZIP I = Ice Z = ZnAcetale To: Telephone# Fax# N = NaOH X = None

Sampled by: Credit Card Info (Include exp. dale) Z'T~^ «-<'h Sampling Location (Specify State); {jy U -<5 0 = Other: Due Date; (Rush TAT requires Lab approval) GL REPORTING REQUIREMENTS (Circle all that apply) Reduced Deliverables Package Electronic Data Deliverables ^servalives (See above Key: Full Data Package all that apply) LIST NPDES MIPP RCRA Stormwater DEP (PWS# ) Type (P=Plastic. G-Glass. A-Alrj

2LU SAMPLE DESCRIPTION Final Air Voluint Matrix Type Sampling Info Container Volume (Liter, etc)

fc (ID must match conUiiier labels) Date Time Number of Containers 1

2 fTV- u £ Hi/firC. or cn 0. 4 5 6 0. o 7 (T-< 8 ,^S 9 LO 10

(1) Relinquished by; Time (2) Received by: Date Time l|(3) Relinquished by; Date Time S® Io □ (4) Received by: Dale Time (5) Relinquished by: Date Time |(6) Received at Lab: Date Time Oh

bO Method of Delivery: UPS ED-EX ) PAS Courier Client US Mail Other co o •cjD

NYC-WTC_000229421