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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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NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ester ov.com WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 | Time/Date Set: QCS / PxPA bib 2A404— NYS-ELAP No. 10108 Form A-70 (rev.1/96)— shkpleTypo totrelsloho) • ■ 3 ** : k table 3. Non Potable Treated Bottle #‘s: P( - "i ■ C 6*3 2. Non Potable 4. Other________________________ Chain of Custody?yes no . ‘ Go Time/Date Collected: _______ 19 30 A 4 Comments: 7462 --------------- Fi5 Collected By: MVasslev Agency Code: _ Source ID: Type Descriptor Collected From: Bill to: Location’s/ndividual’s Name Ows Name/Company Street____________________________ Street_____ _ City/St/Zip___________________ ■ ______________ City/SVZip ______ ___________________________________ Identification of Source __ _________ Collection Point 7 / CO / / KepiAos. . Phone#: Fax#: • 2.290CACH.BR***Checki ■ 'Amo^#" _____ _______ ____ : ■ a ‘A .... ( __________ 424 xdoaRert

BACTERIOLOGICAL ANALYSIS Lab#:____________________ . ORGANIC POTABLE ANALYSIS Lab#: 2p"8 ! • OFIGAN1C NONPOTABLE/SOLID ANALYSIS S.:.. (circle tests) (circle tests) 1. Heterotrophic Plate 1.Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 22. P.oo ‘a Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) 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.Pesticides/PCB screen (508) 7. Methoprene (616)

Gr— 8. PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) TO. Pesticides (525) 8. Herbicides (EPA1978/8151) 9. Pesticides (SM18/6630) 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 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) IS. Other----- a4L 18. Other___________________ ____

INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 7087 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.CobaIt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil an Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron TCLP (olids. Suspended 34. Phosphorus Total as P 53.Lead 71 .TCLP-Metals 19. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55 Manganese 73.TCLP-Herbicldes 18. Solids, Total Volatile 37. Surfactants 56. Mercury 38. UV254 57 Molybdenum 74. TCLP-Volatiles 19. Other:_ _______________ 75.TCLP-BNAs 58. Nickel .rtss. NYC-WTC_000026266

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