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Sample submission form, Aug 2001

Machine-extracted title · confidence 90%

Form used to submit environmental water samples to Westchester County Laboratories with chain of custody documentation.

NYC-WTC_000025775–000025840

Folder label: “22166 - 22171

Page image
Scanned page image, NYC-WTC_000025781
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Date:. 4/20/ . New York City Department of Environmental Protection Kensico Laboratory Day: echevda/ Keypoint Chain of Custody Form # OF BOTTLES COLLECTED

is Ph9 .2£a II 8t 68 fi 9 f &X f2 6 1 XE2 fi9 E & O s tno 88 $< ii & S

SITE LOG NUMBER TIME Oa • • 2,. 14 Q. . C E 2 to a E 2. m E a. u C 8 si

CATLEFF 630/ 6737 1 1 1 DEL18 6302 -0822 1 1 /

CATEV 460323727003 L DEL19 094’1420017 1 DEL170 +6 46971109 L CATALUM 042g3/042 (

CROGH CROGHC CRO1T CRO1B CROGH1 CRO9 4399 0Q0Q 1 RO18Q

B&%— /)0r 640 / /202 ) )

HgDUP HgMB PCBDUP PCBMB COMMENTS:

Relinquish ad by: Sample «s: Date/Time RECEIVED BY CHEMISTRY: RECEIVED BY MICRO: 7/2-0/ RECEIVED BY INSTRUMENTS: 2/2/0/ 3/c£214%% QAzf / Y5 (Date/Time) 2m (Date/Time) (Date/Time)

Ri ) Sample is:) (“ODterrime ,

1/6372- 0-/2-0,’ RECEIVED BY CHEMISTRY: 131 MECEIVED BX MICRO: 11- 0] D I (Datemme) RECEIVED BY INSTRUMENTS:

LA 6340 1^00 I/n /olatarina (Date/Time)

Reline Sample Ns: Date/Time 'RECEIVED BY CHEMISTRY: RECEIVED BY MICRO: RECEIVED BY INSTRUMENTS:

(Date/Time) (Date/Time) (Date/Time)

“All samples collected, preserved, and transported according to Division SOP guidelines.

NYC-WTC_000025781

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NYC-WTC_000025781Source: NYC Law Department, mirrored locally

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Chain of custody form, Sep 2001 · Box DEP Box 19

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Chain of custody form, Sep 2001 · Box DEP Box 19

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Record documenting the chain of custody for samples submitted to the Westchester County Department of Labs & Research.

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Water analysis report, Sep 2001 · Box DEP Box 19

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Laboratory report detailing chemical analysis results for water samples collected in September 2001 at the Westchester County Lab.

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