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Chain of custody record, Westchester County Lab, Sep 2001

Machine-extracted title · confidence 95%

Document tracking sample transfer and custody for environmental testing at the Westchester County Department of Labs & Research.

NYC-WTC_000025875–000025889

Folder label: “22542 - 22558”

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NYC 9/11 Public Portal Document **m** • Pts --

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ster WESTCHESTER COUNTY LABORATORIES AND RESEARCH iv.com 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 Time/Date Set: Form A-70 (rev.1/96)

W pleType (circle one): 28063 63 otable 2. Non Potable 3. Non Potable Treated 4. Other j /_______________ Bottle _ _______ Chain of Custody? yes no Time/Date Collected: 2/s/0//6/0 Comments: Collected By: _ VA/A S Agency Code: PWS#:_______ Source ID: Type Descriptor: _ Collected From: Bill to: Location’s/Individual’s Name 4A- 6/6c/A Name/Company Street___________ SAALES. Street________ City/St/Zip_________ City/St/Zip Identification of Source Phone#: Fax# Collection Point.-2/7 3/850 CA.CH. BM*E5 checki’" " • Amounts 207 . *34 *% ■ ; =.70 raocnaa’a

BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANAVsisHa oRGANIC NONPOTABLE/SOLID ANALYSIS Lab#:_______________ ____ Lab#:______________ ______________________ (circle tests) (circle tests) j" 1. Heterotrophic Plate C Trihalomethanes (524) A 2 irgeable Halocarbons (624/8260) Count (hemodialysis & all others) (2. Volatile Halocarbons ($24) 6 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) (3 Volatile Aromatics (524 _ 3. Acrolein & Acrylonitrile (624) f 3. Coliform MPN (priv well, raw, stp) 4. Fecal Coliform (all samples) (2 Total Trihalomethane Potential (510) 4. Phthalates (625/8270) 5. Organochlorine Pesticides (608/8081 ; s 5. Microscopic 6. Macroscopic 5. Microextractables (504) & Pesticides (507) 6. PCB’s (Arochlors) (608/8081) i *2 2 Pesticides/PCB screen (508) 7. Methoprene (616) Gr— Refrigerated? yes no 8. PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) d0 Pesticides (525) 8. Herbicides (EPA1978/8151) 9. Pesticides (SM18/6630) 10. Petroleum Hydrocarbon Scan (310-13)' 6*

11. Carbamate Pesticides (531) 11. Glycols 2 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. Pesticldes/PCB’s (DEF) 18. Other________ ;______________ 18. Other________________________

INORGANIC ANALYSIS REQUESTED - Lab#: i (circle tests) 1. Color 20. Acidity 39. Aluminum 59. Potasslin C - 2. Turbidity 21. Alkalinity, as CaCOs 40. Antimony 60. Seleniur i wt aosi

3. pH 22. Bromide 41. Arsenic 61. Silver ee 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 CaCO3 46. Calcium, as CaCOs CLP J 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 SO.Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil an Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron 53.Lead TCLP lids, Suspended 34. Phosphorus Total as P 35. Phosphorus, Ortho as P 54 Magnesium 71 TCLP-Metals lids, Total 72.TCLP-Pestlcides 17. Solids, Total Dissolved 36. Sulfates 55 Manganese 73.TCLP-Herblcides 18. Solids, Total Volatile 37. Surfactants 56. Mercury 38. UV254 57 Molyodenum 74. TCLP-Volatiles • 19. Other________________ 75.TCLP-BNA’S 58. Nickel _= _daddhaai NYC-WTC_000025885

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