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Document fragment from DEP Box 19 folder 22470-22496

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Fragmented document page from environmental protection department records containing identification numbers.

NYC-WTC_000025697–000025710

Folder label: “22470 - 22496

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NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ester rov.com

Time/Date Set: WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 (9 NYS-ELAP No. 10108 Form A-70 (rev. 1/96) CpleType (circle one):

1.Potable 3. Non Potable Treated Bottle #s: 7658 2. Non Potable 4. Other___________ Chain of Custody? yes no Time/Date Collected: _{(es Vece tr5 Comments: Collected By: W I MT Agency Code: _ Source ID: .Type Descriptor: Collected From: Bill to: Location's/Individual's Name Asautew) ASUR Name/Company Street________________ Street________ City/St/Zip________ _ City/St/Zip_____ Identification of Source Phone#: _ _____ Fax Collection Point “ =DwSp * CA,CH, Bl? Check#: Amount$ *t 48 ': ■ BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#:_________ _ (circle tests) 2-743- 1. Heterotrophic Plate 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2. Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) f 2. Coliform P/A (public supplies) 3. Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 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) 5. Microscopic 6. PCB’s (Arochlors) (608/8081) — 6. Macroscopic $ Pesticides (507) 7. Methoprene (616) Pesticides/PCB screen (508) 7_API 8.PCB 1 as Decachlorobiphenyl (508A) 8. Herbicides (EPA1978/8151) _ 9. Herbicides (515) 9. Pesticides (SM18/6630) Refrigerated?yes no ‘10 Pesticides (525) 10. Petroleum Hydrocarbon Scan (310-13) -I. Carbamate Pesticides (531) 11. Glycols Chlorinated:? yes no 12. Glyphosate (547) 12. Acid Extractables (625/8270) 13. Diquat (549) 13. Base Neutral Extractables (625/8270) Free Chlorine Res:. mg/L 14. Chlorination Disinfection Byproducts (551) 14. GC/MS Semivolatile Unknown Scan Total Chlorine Res: mg/L 15. Haloacetic Acids (552) 15. Purgeable Halocarbons (DEF) 16. Pesticides (SM18/6630) 16. Purgeable Aromatics (DEF) pH 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pesticides/PCB's (DEF) 18. Other_______________________ 18. Other_______________ :________

INORGANIC ANALYSIS REQUESTED - Lab#: CO (circle tests) -C 1. Color 20. Acidity 39. Aluminum 59. Potassium 2. Turbidity 21. Alkalinity, as CaCOs 40. Antimony 60. Selenium' 3. pH 22. Bromide 41. Arsenic 61. Silver : 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium ; 5. Corrosivity (temp: .»C) 24. Chloride 43. Beryllium 63. Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOs 46. Calcium, as CaCOs CLP 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca*2 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 13. Solids, Percent (%) 32. Oil an Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron 34. Phosphorus Total as P 53.Lead TCLP g Solids, Suspended 71 .TCLP-Metals W Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 72.TCLP-Pestlcides 17. Solids, Total Dissolved 36. Sulfates 55 Manganese 56. Mercury 73. TCLP-Herbicides 18. Solids, Total Volatile 37. Surfactants 57 Molybdenum 74. TCLP-Volatiles 19. Other:________________ 38. UV254 75.TCLP-BNA’s 58. Nickel istinis NYC-WTC_000025704

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NYC-WTC_000025704Source: NYC Law Department, mirrored locally

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