Chain of custody record, Westchester County Lab, Sep 2001

NYC 9/11 Public Portal Document ■ ' ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM' : " M (*a* WESTCHESTER COUNTY LABORATORIES AND RESEARCH 6y£ 2 Dana Road, Valhalla, New York 10595 = (914) 593-5575 == szaki Rat

rime/Date Set: 65D1 . csskateTELAPNo,10108 /smA*8— cast (Eom-70 (rev.1/96)% s.So 1r 22/6704 6 ,78 i 1. Potable.— 3. Non Potable Treated Bottle#s:“(93,181,4.1 — /Aa -e# "7 2. Non Potable 4. Other_____________ Chain of Custody? . ... .. yes... . no 9 —ml Time/Date Collected: /Q/ 42-0/ Comments: Collected By: AW/BA _.. _ Agency Code:____ PWS #:... _... _ Source ID:________ Type Descriptor: _ Collected From: Bill to: ,s■ si Location’s/Individual’s Name. . NY De0 Name/Company Street _/2..lal ___.. ... _.. _ Street City/St/Zip _Ai 144 : A. l / - City/St/Zip.. ...... Identification of Source Phone#:______ . Fax#: Collection Point _L/ % z (s ...... 1.. n.. ....... l CA,CH, Bl?...... _ Check#: _ Amounts _ ep ...................... ... ................. ....... ......... —T1 P4C .'I ; nd At *aAiSS ORGANIC POTABLE ANALYSIS (is it NDNNCA115S06* ANALYSIS ’ Lab#: ___ ____ ________ Labt —T circle tests'. 1. Count Heterotrophic Plate _ (circle tests) 1—Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) "I W (hemodialysis & all others) 2. Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) ' A 2. Coliform P/A (public supplies) ^/Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) N 3. Coliform MPN (priv well, raw, stp) 4 Total Trihalomethane Potential (510) 4. ■ Phthalates (625/8270) ' ® 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) W 5. Microscopic 6-Pesticides (507) 6. PCB’s (Arochlors) (608/8081) # W

7. s: Macroscopic

0 47. Pesticides/PCB screen (508) a ' . )** : i ■>. 1 i .. . . 9-Herbicides (515) : 8, Herbicides (EPA1978/8151)_ 7. Methoprene (616) 9. Pesticides (SM1 8/6630) “ 8

Refrigerated? _ yes___ no (10./Pesticides (525) Me Carbamate Pesticides (531) m 1 .Glvcols= 10. Petroleum Hydrocarbon Scan (310-13)48,

Chlorinated:? yes .. no

Free Chlorine Res:..... . .... .. mg/L 12. Glyphosate (547) 13. Diquat (549) 12. Acid Extractables (625/8270) 13. Base Neutral Extractables (625/8270) 11 ■ 14. Chlorination Disinfection Byproducts (551) 14. GC/MS Semivolatile Unknown Scan 15. Haloacetic Acids (552) 15. Purgeable Halocarbons (DEF) Total Chlorine Res: _............. mg/L 16. Pesticides (SM18/6630) 16. Purgeable Aromatics (DEF) . pH _ 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pesticides/PCB’s (DEF) I 18. Other:___ 18. Other:__________________ __ ___ _ _ ------------- ---------------------- :------------------------------ =------- — 7 1 INORGANIC ANALYSIS REQUESTED - Lab#:..... 1 (circle tests) 1. Color 20. Acidity /39MAluminum /59. Potassium 2. Turbidity 21. Alkalinity, as CaCO3 | 40. Antimony | 60.\Selenium 3.pH 4. Conductivity 22. Bromide 23. Bromate/Chlorate/Chlorite 41. Arsenic 42 Barium 1 61. Silver 62. podium 43! Beryllium

2627,25.Cvanide 5. Corrosivity (temp:_____ °C) 24. Chloride 63. Thallium 6. BOD (5 day) 7. Soluble BOD (5 day) 8. Carbonaceous BOD (5 day) Fluoridess, Total asd , Hardne 44. Boron /45. Cadmium. CaCOs (47.Calcium, +2 46. Calcium, as CaCOs (.! v ( 65/Zinc ICLP== h>:u>

9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N Ca 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N :48.Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromium, Hexavalent 68. Semi-violatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50:Cobalt 69. Pesticides/PCB's I । 51 .Copper

— 52. Iron 32. Oil an Grease an 4 3, Solids, Percent (%) 70. Disk Deliverables ' Solids, Settleable 15ids, Suspended .33. Phenol 34. Phosphorus Total as P i 53 .Lead TCLP 71 TOLP-Metals ■ 165blids, Total 35. Phosphorus, Ortho as P { 54 Magnesium 72,TCLP-Pesticides 37. Surfactants —156.Mercurv.clts 17. .Solids, Total Dissolved 36. Sulfates 55 Manganese 73. TCLP-Herbicides 18. Solids, Total Volatile 19. Other: de 38.UV254es157 Molybdenum—and 74. TCLP-Volatiles ■■ 58 Nickel . 75. TCLP-BNAS

NYC-WTC_000025642