Chain of custody record, Westchester County Lab, Sep 2001

NYC 9/11 Public Portal Document

Ill ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LASORATOHITS AND Pest ARCH 2 Dana Road, Valhalla, New York 10595 . ' ***: ,0(914) 593-5575/ T' . /c NYS-ELAP No. 10108 /Date Set: Q( Cob, 68yA/2/a0lay7FormA-70(tev.1/96)_ pie Type (circle one): 4. a p S, P 060 y- u 7 C- $5 1. (Potable 3 Non-Potable Treated Bottle #‘s:GEGsk/ 4. Other_ 2. Non-Potable Time/Date Collected:AL2/ Aes.2-ki Chain of Custody?_____ yes_____ no — Comments Collected F ** **2-0n ...Agency Code:___ j PWS #:___ __ Source ID:________ Type Descriptor:____ Collected From: Bill to: Location’s/Individual’s Name NIC. DEP. ... _ __ ■ Name/Company_ Street_____ 1 /lake.. .. __ Street__________ cty/StZip_ Vehella : r_ 125A9. ... . —City/StZip Identification of Source________________ ___ ...... _____ Phone#:___ ___ _ Fax #: Collection Point__ _OGH_ _ _ [ CA. CH, BP Check#: Amounts

Bnc ! i ith 1 . ; ANALYSIS organic Pol Adil i ana: r’i $ chi AKC NONOIAs { i) I[ ANALYSIS Labii__ ___ ________________ Lab#—— (circle tests) 1. Heterotrophic Plate ' • (circle tests)eee j 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) d 2— Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2 Coliform P/A (public supplies) 3. Coilform MPN (priv well; raw, stp) 4. r ecal Coliform (all samples) 4.3. Volatile Aromatics (524) ■ 4. Total Trihalomethane Potential (510) i 5. Microextractables (504) 4. Phthalates (606/8060) ■ 1 - " A. i vlonse (6,* 1) ■ lia .is. Pedtp** :■ (60H s.5m 116 RGB's (Arochlors) (608/8080) | 5. Microscopic ; j 6. Macroscopic Y.ARLM .9, Herbicides (515) _ : 6. Pesticides (507) —7.Herbicides(SM-18/6640:8151) C2 Pesticides/PCB screen (508) 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630)

Refrigerated? _ _ yes_____ no ( 10, Pesticides (525)-10. Glycols in Water " 11. Carbamate Pesticides (531) "9. Petroleum Hydrocarbon Scan (310-13)

11. Acid Extractables (625/8270) 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) Chionnated": _...... yes______ no 1113. Diquat (549) e 14. Chlorination Disinfection Byproducts (551)i 13. GC/MS Unknown Scan 14. Purgeable Halocarbons (DEF) | Free Chlorine Ros:_ mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) 16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) 5 Total Ch’srine Res: ___ mg/L 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF)

pH I 1*665 AKAIYSNOUS/tD — (circle tests) e yY 1Coorf 2.—Turbidityuev 20. Acidity 39, Aluminum 59 Potassium :

4140 ‘21. Alkalinity, as CaCO3 Antimony 4. Selenium 3pH 22. Bromide Arsenic 61 Silver J ■ 4. 5 Conductivity 24.Chlorideoee Corrosivity (temp:______ °C) 23. Bromate/Chlorate/Chlorite 42) Barium 43. Beryllium Sodium CA Thallium

ppmn uoriddee —yetmgs 26. FlCyani 7, Soluble BOD (5 day) 25. C. BOD (5 day) 44. Boron (45. Cadmium 64 Vanadium 1(5 /mr: CLP 8. Carbonaceous BOD (5 day) ■ 27. Hardness, Total as CaCOa 9. Chemical Oxygen Demand 10. Dissolved Oxygen 28. Nitrogen, Ammonia as N 46. Calcium, as CaCOa (47 Calcium, Ca+“ 66.Metals/CN 67. Volatiles 11.Total 12. Total Organic Organi c Carbon Halides ■ -29. Nitrogen, Nitrate as N • 30. Nitrogen, Nitrite as N Chromium, Hexavalent Cobalt!!?- 48. Chromium, Total fit Near v ol.s

13. Solids. Percent.(%)_ 32. 011 and Grease .31. Nitrogen, Total Kjeldahl as N 88 51. Copper — t Ptica* 0 " P l ** ! hshyo *e 133 Phenol 9 52. Ironbd TCLP" ML "■

g16. Solids. Total Maa '35. 34. Phosphorus. Phosphorus, Ortho asPPe Total as Let 54,3 Leadses MagnesiumEierel 71.TCLP-Metals 17.18, SolSoliidds,s. Total Total Dissolved Vol a ti l e —A —36. Surfactants L M37 S Sulfates_ _Merc ManganeseAoaou ury.M 55 n ll a ! Podt. /3 tl:: P ! sperlom idle ,

t a 19.OtherlSnTtond 38.UV254Mmd— 57. Mol y bdenum—t 1158. Nickel a. E 156 i 101 1 V ‘iter 75.TCLP-BNA‘s N YC-WTC_000026516 ssesnnea