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Chain of custody record, Westchester County Labs, undated

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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_000026611–000026618

Folder label: “23497

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NYC 9/11 Public Portal Document TPPRP *"*** t Jptspr*e*sear*s"eAn •onpyaas

------------------------- A l _________

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM

III UJestchester County Tme/Date Set: WESTCHESTER COUNTY LABORATORIES AND RESEARCH

__________________ — 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 Form A-70 (rev. 1/96) Sample Type (circle one): 8S89. 3590. 8653, 8630, 8634 1 Potable 3. Non-Potable Treated Bottle ws:DDS!3"40,7391,329/,09/76s91 2. Non-Potable 4. Other _____ ____________ _ Chain of Custody? yes .no Time/Date Collected: 9/29200/ 09"> Comments: Collected ByE basoouscs Agency Code: _ Source ID: .Type Descriptor: Collected From: Bill to: Location’s/Individual’s Name. PjonA Name/Company Street______ ___ ________ Street__________ _ City/SUZio City/St/Zip______ ' u(BtP LAB i Identification of Source. Phone#: Fax#:, Collection Point hi so 28720 CA, CH, Bl?, as Check#: Amounts, . 1 * BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTAB YSES Lab#: (circle teste) 2005 — ■ ’ .. . 1 ; . , Lab#: (circle tests) 2503 - W. 152 : 1. Purgeable Halocarbons (624/8260) r 1. Heterotrophic Plate .. .1. Trihalomethanes (524) 2. Purgeable Aromatics (624/8260) 2" Count (hemodialysis & all others) ! 24 Volatile Halocarbons (524) 2. Coliform PIA (public supplies) 4.3.7 Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) Y * 3. Coliform MPN (privwell, raw, stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) 80 s • 2e 4. Fecal Coliform (all samples) - . 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080)* 5. Microscopic . .. c . > ; 6. Pesticides (507) 6. PCB's (Arochlors) (608/8080) ; 2$ • 6. Macroscopic . h (7. Pesticides/PCB screen (508) 7. Herbicides (SM-18/8640; 8151) * 7. API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) . 59 _: 9. Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-1 3) * (.10. Pesticides (525) 10. Glycols in Water 24 . • Refrigerated? yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 2

... < 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) 5 Chionnated?: .yes no 13. Diquat (549) f f 13. GC/MS Unknown Scan r : 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chiorne 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) 0+ pH

INORGANICANALYSES REQUESTED - Labs (circle tests) -------- ir bwms // co - 1. Color 20. Acidity 39. Aluminum 59. Potassium C 2. Turbidity 21. Alkalinity, as CaCOs 40. Antimony 60. Selenium; 3. pH 22. Bromide 41. Arsenic 61. Silver s 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 CaCO3 46. Calcium, as CaCO3 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-volatites 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 10. 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 - -‘========= S56 -* « NYC-WTC_000026618

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