NYC 9/11 Public Portal Document
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WESTCHESTER COUNTY LABORATORIES AND RESEARCH
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2 Dana Road, Valhalla, New York 10595
(9141,5935575
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NYS-ELAP No. 10108
Form A-70 (rev. 1/96)
imple Type (circle one): 6013,80901005/,8o",3050,30S1,0271
1) Potable 3. Non-Potable Treated Bottle ws&lol(,83893080,80986011QFP
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2. Non-Potable 4. Other____________________ Chain of Custody? yes no
Time/Date Collected:2/2M/200/—929
Comments:
Collected ByC - 1 su l_________ Agency Code: PWS #: .Source ID:. .Type Descriptor.
Collected From: Bill to:
Location’s/individual’s Name. __ _______________ Name/Company
Street______ _ ________________ _ ____________ .. Street
_______________ :___________ _______________ Citv/SUZi
Identification of Source-. DeDLAO* Phone#: Fax#:
Collection Point . 4/2150 2894 2— _ | CA, CH, Bl? Check#: Amounts.
BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES : ORGANIC NONPOTABLE/SOLID ANALYSES
Lab#: .
(circle tests)
Lab *_U44:
(circletests) . . 2. / •/ ‘
: .-■
1. Heterotrophic Plate 1. Trihalomethanes (524) 7 e 1. Purgeable Halocarbons (624/8260)
Count (homodialysis & all others) 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) 63
4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 2 ?
5. Microscopic 6. Pesticides (507) . 6. PCB’s (Arochlors) (608/8080)
6. Macroscopic - 7. Pesticides/PCB screen (508) . 7. Herbicides (SM-18/6640; 8151) 17
7. API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630)
BeOther: ________ 9. Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) '
i 10. Pesticides (525) . 10. Glycols in Water
Refrigerated? yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) "
12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) 7
Chlorinated?:____ ves no 13. Diquat (549) 13. GC/MS Unknown Scan
14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF)
Free Chlorine Res: mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF)
16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF)
Total Chlorine Res: mg/L 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF)
pH
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INORGANIC ANALYSES REQUESTED - Lab#:
(circle tests) C. -•
1. Color 20. Acidity 39. Aluminum 59. Potassium •s "
2. T urbidity 21. Alkalinity, as CaCOs 40. Antimony 60. Selenium l 2
3. PH 22. Bromide 41. Arsenic 61. Silver : ((/
4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium f
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 CaCO3 46. Calcium, as CaCOa 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
14. Solids, Settleable 33. Phenol 52. Iron TCLP
Golids, Suspended 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals
T9.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 qA *
74. TCLP-Volatiles
19. Other:____________ 38. UV254 57. Molybdenum 75. TCLP-BNA’s
mosoncenen 58. Nickel _____ -----------
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