NYC-WTC_000229582

NYC 9/11 Public Portal Document

3 PSC Analytical Services Ou r\ PSC Work Order# u 4418 Pottsville Pike Reading, PA 19605 phone; (610) 921-8833 CHAIN OF CUSTODY Page L of t to o ro fax: (610) 921-9667 or 921-8407 o PO# Quote# CD

Report Name C2o V-w. JOB ID: g> UI x] Company l^gfo CxcUb, Twe, Cu Results Mailing Address (eg- JL.<^ TL (d ANALYSIS REQUESTED To; City State > Ao Use attachments if necessary.

Telephone * avge. Fax# jj. Please specify method requirements. Preservatives Key: -D cn Name A 'Ascorbic Ac'd n Submit Company C = HCI N2 = NaS2O3 Mailing Address H = HNO3 S = H2SO4 Invoice City Slate ZIP I'Ice Z - ZnAcetale To: Telephone # Fax# N = NaOH X = None Credit Card Info (include exp, date)________________________________________ _________ Sampfdd by: Sampling Location (Specify State); ~ V O = Other: Due Date; ______________ (Rush TAT requires Lab approval) Oh glEPORTlNG REQUIREMENTS (Circle all that apply)

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=Airj

2 SAMPLE DESCRIPTION Final Air Volumt Matnx Type Sampling Info Container Volume (Liter, ek) (ID must match container labels) Dale Tunc Number of Containers tn

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Q 4 I CD H 5 cn r 6 2 74 cn I—t s o £ o 9 I o 10 o (1) Relinquished by: Date Time U) Received by; Dale Time (3) Relinciuished by: [ Dale Time O CO T) iC. (d) Received by: Date Time (6) Relinquished by Dale Time (6) Received I—t ro NO

NYC-WTC_000229582