Chain of custody record, Westchester County Lab, Sep 2001

NYC 9/11 Public Portal Document Gm Vesluls ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 94 ).s ' • H Msn ats 2 Dana Road, Valhal a, New York 10595 _(9141593-5575 a _NSELAPNo101 d"ate Set: E20a12FormA-70(rev.1/96) Sample Type (circle one): c-7852K-792/799/790/78M (Potable) 3. Non Potable Treated PCOG5PFB15Y&,R*4,P244,AfA*5.R* 2. Non Potable 4. Other Chain of Custody?—yes _ no -- Time/Date Collected: _ Q25_ Collected By _W_r_ AFWP Agency Code: Commenkst PWS #: __ Source ID: _________ Type Descriptor: i C leet,d l rom. Bill to: Location’s/Individual’s Name .C zk — Name/Company Street__ Vi ) "b A Street City/St/Zip _ Ue Ji • t ; City/StZip identification of Source . Phone#:........... _ Fax#:____ Collection Point _ 1" CA,CH, Bl? ...... Check#: Amount$_

BACTERIC 14310 r2 ANAIYSIS RGANC POTA.E ANALYSES XGNNONPOTAELES0U 19) ANALYSIS Lab#: Labi: :... ..... -22 I (circle tests) (circle tests)_/_d/nd 1. Heterotrophic Plato Count (hemodialysis & all others) 1.Tri (2, olhalomethanes(524)d atile Halocarbons (524) the 2. Purgeable Aromatics (624/8260) P i ; t.i. !1 216 (4/50)

2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 3 3. Volatile Aromatics (524)—eee 4. Total Trihalomethane Potential (510) 3, Acrolein & Acrylonitrile (624) 4. Phthalates (625/8270) ' -s 3 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) it 5. Microscopic 6. Macroscopic • 4 §_ Pesticides (507) Z7-Pesticides/PCB screen (508) 7.Methoprene(616)Tngatdon 6. PCB’s (Arochlors) (608/8081)

Q Pesticciiddeses (515) (10.9. Herbi e ■ 8.,‘PCB as Decachlorobiphenyl (508A) 8.. Herbicides (EPA1978/8151) oeeether:__ 9. Pesticides (SMI8/6630) . (525) 10. Petroleum Hydrocarbon Scan (310-13) _ Refrigerated?____ yes

Chlorinated:? yes no

no 11. Carbamate Pesticides (531) 11. Glycols—"—eae 12. Glyphosate (547) 12. Acid Extractables (625/8270) ■ 13. Diquat (549) 13. Base Neutral Extractables (625/8270) 2 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) 18. Other: • 18. Other /I INORGANIC Ah At y SIS RE QUEST ED - (circle tests) 1. Color 2. Turbidity 20. Acidily 21. Alkalinity, as CaCO3 tdalhyibbaZ i 39; Aluminum ‘ — ( 40. Antimony ‘* l’<rrudto ! 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 i 63. Thallium " 647 6. BOD (5 day) 25. Cyanide 44. Boron | 64./Vanadium 7. Soluble BOD (5 day) 26. Fluoride i 45.Cadmium (65,Zinc / 8. Carbonaceous BOD (5 day) 9. Chemical Oxygen Demand 27. Hardness, Total as CaCOs 28. Nitrogen, Ammonia as N ’46. Calcium, as CaCOs 47Calcium, Ca*2 ICLP--- 2 Notal 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N 48.Chromium, Total /. y i iten 11. Total Organic Carbon to N:!:: n r i Nit i . r 49. Chromium, Hexavalent 8 : mi-vn:. atiloa 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N /50.Cobalt :). i caloiio i : CIs 32. Oil an Grease 51.topper a) 52. ron 28590 13. Solids. Percent (0) 70. Disk Deliverables 33. Phenol . Solids, Settleable tSolids, Suspended 34. Phosphorus Total as P 53.Lead TCLP 71 TCLP-Metals i

54 Magnesium TH Solids, Total

37. Surfactants 17. Solids, Total Dissolved —ee 5556. Manganese 35. Phosphorus, Ortho as P

Mercury rents 36. Sulfates 72. TCLP-Pesticides / t. IGWPileducl ‘

i 19. OtherCm 38.UV254sdst .MSA 18. Solids, Total Volatile 57MolNickel yodenum nsh“Sr M1 ICLP/Volits /5. ICLBNAs

NYC-WTC_000026405