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Chain of custody record, Westchester County Lab, Sep 2001

Machine-extracted title · confidence 90%

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

NYC-WTC_000026260–000026267

Folder label: “23079

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Scanned page image, NYC-WTC_000026262
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NYC 9/11 Public Portal Document

19

Time/Date Set: ster iv.com « ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM .. WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575

4 . i 2: 48

(s uw NYS-ELAP No. 10108 Form A-70 (rev.1/96)

Sample Type (circle one): 045s_ 1040,5225 !1. Potable 3. Non Potable Treated Bottle #s: ^1, ( 211 7 2 3 20 22 9 4242 2. Non Potable 4. Other__________ Chain of Custody? _ yes no Time/Date Collected: 9/30/2001_____ 22:25 Ana. Comments: Collected By: A2A/7 / aencv Code: _ Source ID: Type Descriptor Collected From: Bill to: Location’s/Individual’s Name Att urew QQcvorv _ Street________________ Street_________ _ City/St/Zip Identification of Source Phone#: Fax#: — icbonenspm ■ 653 Collection Point CA,CH, Bl? 02678 Check#:. “Amous— BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS j, Lab#:____________________ Lab#:______________________ (circle tests) (circle tests) 1. Heterotrophic Plate 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2) Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 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. Pesticides (507) 6. PCB’s (Arochlors) (608/8081) 6. Macroscopic 7. 8. a C Pesticides/PCB screen (508) PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) 7. Methoprene (616) 8. Herbicides (EPA1978/8151) 9. Pesticides (SM18/6630) 10) Pesticides (525) 10. Petroleum Hydrocarbon Scan (310-13) Refrigerated? yes no 11. 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 mg/L 15. Haloacetic Acids (552) 15. Purgeable Halocarbons (DEF) Total Chlorine Res: 16. Pesticides (SM18/6630) 16. Purgeable Aromatics (DEF) pH 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pestlcldes/PCB’s (DEF) 18. Other:. 18. Other________________________

INORGANIC ANALYSIS REQUESTED - Lab#:___ 6 (circle tests) 1. Color 2. Turbidity 20. Acidity 21. Alkalinity, as CaCO3 22. Bromide 39. Aluminum 40. Antimony 41. Arsenic hder 59. Potassium 60. Selenium 61. Silver 3. pH 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 TCLP 15lids, Suspended 34. Phosphorus Total as P 53.Lead 54 Magnesium 71 TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 72.TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55 Manganese 73.TCLP-Herbicides 18. Solids, Total Volatile 37. Surfactants 56. Mercury 38. UV254 57 Molybdenum 74. TCLP-Volatiles 19. Other________________ 75. TCLP-BNA's 58. Nickel ssluk NYC-WTC_000026262

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