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Chain of custody record, Westchester County Labs, Sep 2001

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Westchester County Department of Labs and Research chain of custody form for environmental samples submitted by the City DEP.

NYC-WTC_000026566–000026568

Folder label: “23359

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NYC 9/11 Public Portal Document TWTPPP 82710002**09*29* *0007TWP w

in ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 Ulestchestar County (914) 593-5575 NYS-ELAP No. 10108 (e/Date Set: *_________________ Form A-70 (rev. 1/96) Sumple Type (circle one): 6000do53,8o57fo57 • 1) Potable 3. Non-Potable Treated Bottle #‘s: 00*^1 8057 e 54 7 24 (l 7 Y / • 2. Non-Potable 4. _ Chain of Custody? yes no Time/Date Collected:9/2 _ ____________ Comments: ' Collected By: • • A0 .Agency Code: PWS _________ .Source ID:. Type Descriptor: Collected From: BUI to: , Location’s/Individuars Name NQ0v t 0 u) vOrI Name/Company Street____________ Street_________ City/St/Zip_________ _ Identification of Source. Phone# Fax #: Collection Point," Dy 3 CA, CH, Bl? Check#: Amounts

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:____________________ (circle teste) Lab _ . (circle tests) 2% 6 1. Heterotrophic Plate 3 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) C 2.Volatile Halocarbons (524) 2. 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 (510) 4. Phthalates (606/8060) 4. Fecal Coliform, (all samples) 5. Microextractables (504) . 5.- Organochlorine Pesticides (608/8080) 5. Microscopic , 6. Pesticides (507) V 6. , PCB’s (Arochlors) (608/8080) 6. Macroscopic ’ ( 7. Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) 7. API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630)

•—9= 11. Carbamate Pesticides (531) Refrigerated? ' yes - nd *. 9. Herbicides (515) ( 10. Pesticides (525) - , 9. Petroleum Hydrocarbon Scan (310-13) .10. Glycols in Water . 11. Acid Extractables (625/8270) 12. Glyphosate (547) .12, Base. Neutral Extractables (625/8270) Chionnated?: A. yes ' no 13. Diquat(549) : 13. GC/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) .14. Purgeable Halocarbons (DEF) Free Chiorine Res: mg/L 15. Haloacetic Acids (552) .415. Purgeable Aromatics (DEF) 16. Other Pesticides (SM-1 8/6630) . £ 16. Pesticides (DEF) Total Chlorine Res:._ _mg/L 17. Petroleum/Hlydrocarbon ;* • * .**. . .. (310-13) Scan • • •' • 17. PCB’s (Arochlors) (DEF) - uy 5 • - iha pH.

INORGANIC ANALYSES REQUESTED - Lab#:. - ----------------- / (circle tests) 1. Color 20. Acidity 39. Aluminum 59. Potassium " / 2. Turbidity 21. Alkalinity, as CaCOs 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-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 51. Copper 70. Disk Deliverables g Solids. Settleable 33. Phenol 52. Iron ISLE w Solids. Suspended 34. Phosphorus, Total as P 53. Lead 71. TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55. Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles 19. Other:____________ 38. UV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel

NYC-WTC_000026567

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