Chain of custody record, Westchester County Lab, Sep 2001

NYC 9/11 Public Portal Document ********** ******z**d*rr-r-rot-Ten/eeen

4 ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAPNo. 10108 Ame/Date Set: Form A-70 (rev.1/96)

Sample Type (circle one): P (1.Potable 3. Non Potable Treated Bottle #‘s: .697000dre/-£ ■i

2. Non Potable 4. Other_________________ Chain of Custody? yes no Time/Date Collected: 9/19/200/ 0900 Comments: Collected By: NSd cheti ! Agency Code: _ Source ID: .Type Descriptor Collected From: | Bill to: Location’s/Individual’s Name . $1 Name/Company 1 r Street_________________ ______ Street________ City/St/Zip__________ Y , 4 —t. _ Identification of Source Pi_________ AePtAB Phone#:______ Fax#: Collection Point 2240L CA.CH, Bl? Check#: Amounts. BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#:______________ ;_____ Lab#:____________________ (circle tests) (circle tests) 1. Heterotrophic Plate 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 4. Fecal Coliform (all samples) 3 Volatile Halocarbons (524) Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) 2. Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) 4. Phthalates (625/8270) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) 5. Microscopic / 6. Pesticides (507) 6. PCB’s (Arochlors) (608/8081) 6. Macroscopic 77 Pesticides/PCB screen (508) 7. Methoprene (616) . @_ 8. PCB as Decachlorobiphenyl (508A) 8. Herbicides (EPA1978/8151) ' . - f - 9. Herbicides (515) 9. Pesticides (SM18/6630) 10 Pesticides (525) 10. Petroleum Hydrocarbon Scan (310-13). Refrigerated? yes no 111. Carbamate Pesticides (531) 11. Glycols / , Chlorinated:? yes—/ 10 / /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: 15. Haloacetic Acids (552) 15. Purgeable Halocarbons (DEF) /16. Pesticides (SM18/6630) 25518/016. Purgeable Aromatics (DEF) . pH _ 17. Petroleum/Hydrocarbon Scan(310-13) 55217, Pestlcides/PCB’s (DEF) < .,8.Qther_==betal&.Other_ _wTTterorcrsmon=------------------------- INORGANIC 1. Color ANALYSIS J NEGyEsTD-uab " 20. Acidity / —2A0252 ‘. TT 39. Aluminum 59. Potassium 2. Turbidity 5 21. Alkalinity, as CaCO3 40. Antimony 60. Selenium 3. pH / 22. Bromide 41. Arsenic 61. Silver 4. Conductivity 23. Bromate/Chlorate/Chiorite 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 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. Pestlcides/PCB’s 13. Solids, Percent (%) 32. Oil an Grease 51. Copper 70. Disk Deliverables Solids, Settleable 33. Phenol 52, Iron 4 Solids, Suspended Solids, Total 17. Solids, Total Dissolved 34. Phosphorus Total as P 35. Phosphorus, Ortho as P 36. Sulfates 8. Lead 54 Magnesium 55 Manganese TCLP 71 .TCLP-Metals 72.TCLP-Pesticides 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

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