NYC Law Department release
Independent mirror · updated as the City releases more · v1.2.6
← Document results/DEP Box 19/23258
Document / 8 pages

Chain of custody form, Westchester County Lab, Sep 2001

Machine-extracted title · confidence 95%

Record documenting sample transfer and custody for environmental testing at the Westchester County Department of Labs & Research.

NYC-WTC_000026351–000026358

Folder label: “23258

Page image
Scanned page image, NYC-WTC_000026354
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ster Westchester county laboratories and research A com 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 Ame/Date Set: QC St Exka 6ottlDAd/~ NYS-ELAP No. 10108 Form A-70 (rev.1/96)

Sample Type (circle one): 1, Potable 3. Non Potable Treated Bottle #‘s: 0 i 4 0 L

2. Non Potable 4. Other ___ _______________________ Chain of Custody? yes no Time/Date Collected: _ / 20 ( 10: 4^ a 4 Comments: Collected By: 8.6etsrk Agency Code: PWS#:_______ Source ID: Type Descriptor: Collected From: Bill to: Location’s/Individual’s Name Byoxy Name/Company Street________________ Street________ City/St/Zip____________ City/St/ZIp pYCBeP LAB# Identification of Source Phone#:______ Fax#: Collection Point 14350 / CA,CH, Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#:_____ Lab#:____________________ T (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) 8 Volatile Halocarbons (524) Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) 2. Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) 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 79Pesticides/PCB screen (508) 7. Methoprene (616) ____________________ • s. PCB as Decachlorobiphenyl (508A) 8. Herbicides (EPA1978/8151) 9. Herbicides (515) 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 714. Chlorination Disinfection Byproducts (551) 14. GC/MS Semivolatile Unknown Scan Haloacetic Acids (552) , Total Chlorine Res: -mol,v 54 115. 16. Pesticides (SM18/6630) 15. Purgeable Halocarbons (DEF) 16. Purgeable Aromatics (DEF) pH . 7 $ 117. Petroleum/HydrocarbonScan (310-13) 17. Pesticides/PCB's (DEF) m= 10o9999p*p**/99*=,/$=2=78T* ■' 1000999n929==9==127 —92-P2*-- 19!!9 ! =?5-?-99!?ng219 915555=====-" 18.. Other:

INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) . A 2 6 —— 1. Color 4. 20. Acidity 39. Aluminum 59. Potassium 2. Turbidity 21. Alkalinity, as CaCOa 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. Cobalt 69. Pesticides/PCB's 13. Solids, Percent (%) 32. Oil an Grease 51. Copper 70. Disk Deliverables 24.Solids, Settleable 33. Phenol 52. Iron TCLP (Solids, Suspended 34. Phosphorus Total as P 53.Lead 71 TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 55 Manganese 72.TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 56. Mercury 73. TCLP-Herblcldes 18. Solids, Total Volatile 37. Surfactants 19. Other________________ 38. UV254 57 Molybdenum 74. TCLP-Volatiles 75.TCLP-BNAS 58. Nickel

NYC-WTC_000026354

OCR can misread numbers and units. Confirm readings against the page image before using them.

NYC-WTC_000026354Source: NYC Law Department, mirrored locally

Related records

Browse subjects →

Ranked by indexed similarity. Reasons describe shared subjects and filing context; check the source records.

Same-box records

Filed elsewhere

No available related records indexed in this group.

More like this page

Similar subjects in other documents. Similarity does not establish the same event, measurement or conclusion.

Page similarity is temporarily unavailable or this page has no indexed vector.

Others also read

Readers open these alongside this record — through an Ask answer, the same folder, or indexed similarity. Not a claim they are about the same event.

NYC-WTC_000026359 · Box DEP Box 19

Laboratory report detailing metal analysis of water samples collected from Hillview Reservoir on September 21, 2001.

Filed in the same folder

NYC-WTC_000026432 · Box DEP Box 19

Record documenting sample transfer and custody for environmental testing at the Westchester County Department of Labs & Research.

Similar indexed content

Compare copies and versions →