NYC-WTC_000229452

NYC 9/11 Public Portal Document

PSC PSC Analytical Services 4418 Pottsville Pike PSC Work Order# ■a T

Reading, PA 19605 CHAIN OF CUSTODY <^o^6Mo4(^ I phone; (610) 921-8833 Page tPl i a ro fax: (610) 921-9667 or 921-8407 a PO# Quote H to Report Name _ JOB ID: n 9 Company -J Results Mailing Address '\CCk (ciTUr^U*- ANALYSIS REQUESTED 01

To: City YiV/A, Slate zip q_______ Use attachments if necessary. Telephone # Pax# A I .g . 'j 2 5 <, C Please specify method requirements. Preservatives Key: T CO Name A = Ascorbic Acid n Company C = HCI Submit N2 = NaS2O3 Mailing Address n = HNO3 S =H2SO4 Invoice City Slate ZIP .1) I = Ice Z = ZnAcetate To;

Sampled by: Telephone ft Credit Card Info (include exp. date) Fax S

t>c .-t^-ak^ampling Location (Specify Slate):______________ 1 N = NaOH

0 = Other: X = None

Of Due Date: y (Rush TAT requires Lab approval) V REPORTING REQUIREMENTS (Circle all that apply) W Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key: list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS # ) Type (P-Plastic, G=Glass, A=Air)

SAMPLE DESCRIPTION Final Air Volumt Matrix Type Sampling Info I Container Volume (Liler, etc)

(ID must match container labels) (L oe<BS^ Date Time Number of Containers m 1 U/J/OO fU/I 2 □ I tfl 3 w 4 I tfl tn 6 tn -J 7 n I—I H s T LO 9 10 n (1) Relinquished by: Dale Time (2) Received by: Dale Time (3) Relinquished by: Date Time 1° r ■5 o o (4) Received by: Date Time (5) Relinquished by. Date Time (6) Received at Lab: X. i j Date Time o rv _______ UD LO <71 Method of Delivery; UPS ED-EX PAS Courier Client US Mail Other

NYC-WTC_000229452