Chain of custody record, Westchester County Lab, Sep 2001

NYC 9/11 Public Portal Document

III ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHCSTOR COUNTY LABORATORIES AND REE!.ARCH 2 Dana Road, Valhalla, New York 10595 Iestchester (ounty 914593-5575 NYS-ELAP No. 10108 e/Date Set: _______ Form A-70 (rev. 1/96) ■ t y i: ■ : ■ • • -■) 224//, A-c/, 74,2,54200/6/ g ~ ***0 6 603 *ss **0 1. Potable 3. Non-Potable Trea'ed 2. Non-Potable 4. Other tot Chain of Custody?_____ yes no Time/Date Collected: _ __ -/ i Comments_ i Collected By: - . _ Agency Code:___ PWS #:_____ Source ID: Type Descriptor: Collected From: Bill to: Location’s Individual’s Name_ Name/Company___ Street__ 2 Street 1071] City/StZip 10 /ly CitviStZi Identification of Source_____ _____ Phone#.__ __ _ — Fax #: Collection Point ARet CA.CH.B? Checkeoido Amount^

• 'C li ‘h * ACAl NALYS S GHGANY PA..i AN6i it % CAAti NONBl ABU AsO tn ANALYSES Lab* Lab #:___ 2 (circle tests) .2. (circle tests) [g. 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) i 3.) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) ‘4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) . t- 4. Fecal Coliform (all samples) 5. Microscopic 6. Macroscopic 5. Microextractables (504) 6. Pesticides (507) 75 Pesticides/PCB screen (508) -6, PCB’s (Arochlors) (608/8080) di 1

-■ < • i-'chhmm- i * lios (C0P/089)

9 (M 18/3v40, bif) ZARI 8. PCE3 as Decachlorobiphenyl (508A) 8.1 Other Pesticides (SM-18/6630) : 9. Petroleum Hydrocarbon Scan (310-13) ' Other:- ' - ‘

gerated?_____ .yes_____ no 9. Herbicides (515) 10, Pesticides (525) T1. Carbamate Pesticides (531) 4 10. Glycols in Water “29 11. Acid Extractables (625/8270) j 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) ' Chionnated?_yes_no 13. Diquat (549) 14. Chlorination Disinfection Byproducts (551) 13. GC/MS Unknown Scan 14. Purgeable Halocarbons (DEF) Free Chonne Res:_ mg/l 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) 16. Other Pesticides (SM-18/6630) 16 Pesticides (DEF) Total Chorine Res: . _ mg/l 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF)

LP . - 81 nsht P s Hi OH! sib . (circle tests) ■ Color e 20. Acidity / 39 Aluminum 59’ Potassium ■ Tulbidity 21. Alkalinity, as CaCO3 ! 40. Antimony 60 Selenium 3. PHGmi B 22. Bromide 41 Arsenic 61 Silver 4, Conductivity 23 Bromate/Chlorate/Chlorite 42 J Barium 62 Sodium Bi Corrosivity (temp:_ _°C) 24, Chloride 44. Boron 43 Beryllium 63 Thallium 25. Cyanide W 26. Fluoride ------ 45 Cadmium . 3 6. BOD (5 day) Vanadium 7. Soluble BOD (5 day) Zinc 8 Carbonaceous BOD (5 day) 27. Ha-dness, Total as CaCOa '46. Calcium, as CaCOa 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 147, Calcium, Ca* 66. Metals/CN 10, Dissolved Oxygen 29. Nitrogen, Nitrate as N (48, Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nit-ogen, Nitrite as N '49, Chromium, Hexavalent 68. Semi-volatiles 50 Cobalt 12. I otal Organic Halides'

"Solids, Settl 13. Solids, Percent (%) e abl e -? 32. 33. 011 and Phenol Grease 31. Nitrogen, Total Kjeldahl as N*

---------- y 51 Iron Copper () ■ ’■ I :■ Cl’ ■ / i )*k l tovoi iles TCLP_n ololiidds.s. Suspended Total Dissolr - 34. Phosphorus. Total as R_ 52 53. Lead 71.TCLP-Metals 72.TCLP-Pesticides 17. 18, Sol Sol i i d d s, s, Total Total Vol a ti l ved . 36. e Sulfates )"-9- 35. Phosphorus, Ortho as P

37. Surfactants eu Mercurv. 54. Magnesium 55. Manganese 73.TCLP-Herbicides 74.TCLP-Volatiles" 19. Other SASmrmts 38.1V254 157 56, Molybdenum 58, Nickel 75.TCLP-BNA‘s reeeedeeenn

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