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Chain of custody record, Westchester County Lab, Sep 2001

Machine-extracted title · confidence 95%

Document tracking the chain of custody for environmental samples submitted to the Westchester County Department of Labs & Research.

NYC-WTC_000026323–000026349

Folder label: “23123

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Scanned page image, NYC-WTC_000026327
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NYC 9/11 Public Portal Document

ill ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ■ WESTCHESTER COUNTY LARMAATORIES AND RESEARCH | 2 Dana Road. Valhalla, New York 10595 ‘

I ik*6k lxii* Gxot 914593-5575 NYS-ELAPNo. 10108 ne/Date Set: Form A-70 (rev. 1/96) ■pie Type (circle one): ror(e (4. 760e ** ! $7,7242.6852.7786 1. Potable 3. Non-Potable Tre&ted iAI57PA-296,4/9,G-Ss.cP-,soc+6 Botte # s:______ (_____________ .________________________ _ __ (__ 2. Non-Potable alolorii 4. Other______________ Time/Date Collected:__ (424 Collected By:L____ __ __ Agency Code:___ Chain of Custody? Comments:, PWS #:____ yes no

___ Source ID:________Type Descriptor;___ Collected From: _tppa*eetedmtee Bill to: d Location's/Individual's Name__ — ____ ___ _ -.... . Name/Company__ street • ----- -........ EGev ; , Akom9/2 Street........... City/St/Zip... __ ___________ ____ _ Crty/St/Zip_........ Identification of Source_ Phone#: Fax #:__ __ :_____ Collection Point___ LC_ CA. CH, BI?.......... Check#:Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES QNGANC NONMOIABL :/$01[ ANALYSES Lab*:___ ___ _ ______ _ _______ Lab #__ ; (circle tests) (circle tests). 11. Count Heterotrophic Plate 2000 (hemodialysis & all others) 1. (2. Trihalomethanes (524) Volatile Halocarbons (524) 1. 2. Purgeable Halocarbons (624/8260) 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 (51 0) 4. Phthalates (606/8060) . ■ 2 | 4. F»x al Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080)* | 5. Microscopic 6. Pesticides (507) :6, PCB’s (Arochlors) (608/8080) . 3 j 6. Macroscopic ' 7 Pesticides/PCB screen (508) 77Herbicides (SM-18/6640; 8151) zAPI 8. PCB as Decachlorobiphenyl (508A) 8 Other Pesticides (SM-18/6630)

10. Pesticides (525) 9! !Petroleum Hydrocarbon Scan (310-13) Other:

igerated?____ yes____ no 9. Herbicides (515)

11. Carbamate Pesticides (531) a 10. Glycols in Water 11. Acid Extractables (625/8270) 2 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) - Chlorinated7:_____ _________no 13. Diquat (549) 13. GC/MS Unknown Scan 14. Chlonnation Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) Free Chionne Res:

Total Chlorine Res: ___ _

_mg/L 16. Other Pesticides (SM-18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) -16. Pesticides (DEF) Mgmda 17. RGB’s (Arochlors) (DEF)

L pH _ _

Ab: A*Alva S HQUS! D . . (circle tests) 000 AWet j 1. Color e 20. Acidity Aluminum 59 Potassium 4 , i 2. Turbidity 21. Alkalinity, as CaCO; Antimony 60 Selenium £ Y/ 3pH j 4. Conductivity 22. Bromide 23. B ro mat e/Ch lor a t e/C h lor it e 41 Arsenic 4,21 Barium 61 Silver 62 Sodium 4 ) 1 I 5 Corrosivity (temp: °C) 24, Chloride 43. Beryllium 63 Thallium 1 C BOD (5 day) 25. Cyanide 44. Boron 64 Vanadium 7. Soluble BOD (5 day) 8. Carbonaceous BOD (5 day) 26. Fluonde 27. Hardness, Total as CaCO3 { 45. Cadmium , 46. Calcium, as CaCOa 65. Zinc__ ____ CLP ~ ~ 47. Calcium, Ca*" ■ • 9. Chemical Oxygen Demand 10. Dissolved Oxygen 11. Total Organic Carbon 28. Nitrogen, Ammonia as N .29. Nitrogen, Nitrate as N 30. Nitrogen, Nitrite as N 4 48/Chromium, Total '49. Chromium, Hexavalent ■ 67. Volatiles Jus, 66. Metals/CN

Ci Geamni vol 1 • . 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N j 60 Cobalt 69. Pesticides/PCB's 13. Solids. Percent (%) 1 Solids, Settleable 33. Phenol gemngnee -53.52,Iron 32. Oil and Grease

Lead j 51/Copper / !), 6 *, in L TCLP sh w r. q*pvri 54.Maanesium 3-1 PAut ph r. -. 1d-[‘ /I. H i IMaal

1118 Solids, Total Volatile A.2.2 36.37.Surtactantss Sulfates 55, Manganese I 73.TCLP-Herbicides 35. Phosphorus, Ortho as P 7 i i P P, " • 17. Solids, Total Dissolved

19 Other ./ 38.UV254 56.Merourv.Mal 57. Molybdenum " / !Cl P V :!.<!;!<■ 75.TCLP-BNA's3 58. Nickel _saansasalacad NYC-WTC_000026327

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