NYC-WTC_000229455

NYC 9/11 Public Portal Document

3 PSC Analytical Services tu CI 4418 Pottsville Pike Reading, PA 19605 CHAIN OF CUSTODY •o CD

phone;(610) 921-8833 Page \ of I CD rd fax; (610) 921-9667 or 921-8407__________________ O PO# Quote # 00

Report Name JOB ID: H Ui^ Cd Company & CaIci-Cii a VsQ. □ 01 Results Mailing Address \ c Cy rfl^ 4O Va ANALYSIS REQUESTED To: Ci'y X<uStale zV/' ZlP/oa / Q Use attachments if necessary. Telephone# Xz <• IJ'J ■ Q Please specify method requirements. Preservatives Key: T3 CD Name A = Ascorbic Acid n Company Submit C = HCI N2 = NaS2O3 Wailing Address H = HNO3 S =H2SO4 Invoice city Stale ZIP I = Ice Z = ZnAcetate To: Telephone # Fax tt N = NaOH X = None Credit Card Info (include exp. dale)

Sampled by: Sampling Location (Specity State); 0 = Other:

Due Date: (Rush TAT requires Lab approval) REPORTING REQUIREMENTS (Circle all that apply) ts Full Data Package Reduced Deliverables Package Electronic Data Deliverables Preservatives (See above Key; ' list all that apply) UST NPDES MIPP RCRA Stormwater DEP (PWS ft ) Type (P=Plastic, r3=Gl3S&, A=Air) at 2 UJ SAMPLE DESCRIPTION Final Air Volume Matrix Type Sampling Info Container Volume (Liter, etc)

(ID must match container labels) (L ef iiiiii) Date Time Number of Containers tn 1 /z/ZYoa ri Cjp — 7 a CD .1 W 4 I CD 5 cn 6 cn ■J

n I—I H 8 l"^ LO 9 10 n (1) R®''^duished Dale Time (2) Received by: Date Time (3) Relinquished by: Date Time 1° TJ o o (4) Received by: Date Time (5) Relinquished by: Date Time (6) Received al Lab: _ ^3te Time o /C.W CQ ^£> LO <71 Method of Delivery; UPS ED-EX N PAS Courier Client US Mail Other <7i LO

NYC-WTC_000229455