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Chain of custody record, Westchester County Labs, undated

Machine-extracted title · confidence 85%

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

NYC-WTC_000026611–000026618

Folder label: “23497

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ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (3) m (914) 593-5575 NYS-ELAP No. 10108 ge/Date Set: ______________________ _ Form A-70 (rev. 1/96) wmpleType (circle one): 8039, 8035,8034,04/ < 0058 1 Potable 3. Non-Potable Treated Bottle #8698,8873, 8052,839 8635 863 2. Non-Potable 4. Other, ________________ Chain of Custody? yes .no Time/Date Collected: 1/2 4/200/ Isol'S Comments:.____ Collected By: S . __ _____________ Agency Code: .Source ID:_______ Type Descriptor:. PWS #:_________ Collected From: Bill to: Location’s/ndividual’s Name. Bookly Name/Company Street________ _________ Street_________ _ ___________________ _ Identification of Source- , DePIAF# Phone#: Fax#: Collection Point " 24290 28431 CA, CH, Bl? Check#: Amounts. t BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES • ' . I ' ' Ps Lab#: . (circle tests). . ■ ■ . ■ ■ Lab#: (circle tests) —AS : " 88p* 1.. Purgeable Halocarbons (624/8260) 1 Heterotrophic Plate 1. Trihalomethanes (524) Count (hemodialysis’& all others) . 2.4 Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260)it 2. Coliform P/A (public supplies) s 3, Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) : 3. Coliform MPN (privwell, raw, stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) sj 4. Fecal Coliform jail samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) y 5. Microscopic . , ' 6. j Pesticides (507) 6. PCB’s (Arochlors) (608/8080) S 6. Macroscopic . ’ ’ ( Jk Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) 7. API 1 : 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) 2 8Other: - _______ 9. Herbicides (515) 9. Petroleum Hydrocarbon Scan (31 0-13) *. . ( 10. Pesticides (525) 10. Glycols in Water 4 Refrigerated? yes_____ no 11. Carbamate Pesticides (531) .11. Acid Extractables (625/8270) — 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) * Chionnated?: yes no 13. Diquat (549) 13. GC/MS Unknown Scan P* 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chionne 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

INORGANIC ANALYSES REQUESTED - Lab#:. (circle tests) 1. Color 20. Acidity _ fr wdaV 39. Aluminum -= > 59. Potassium; ( C 7 $2 *

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 CaCOa 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_________ 14. Solids, Settleable 33. Phenol 52. Iron TCLP Colids, Suspended 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals To. 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 ===-=--lLLtnkShodckc z NYC-WTC_000026617

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NYC-WTC_000026617Source: NYC Law Department, mirrored locally

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