Chain of custody record, Westchester County Labs, undated

NYC 9/11 Public Portal Document tshyne

XP+"‘eil er ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ", el’s.com WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 . i NYS-ELAP No. 10108 Time/Date Set: Form A-70 (rev.1/96) -—======== Sample Type (circle one): "A ' * ’ 07.27, / T". ' 715 . $ / ( 7 Potable ;3. Non Potable Treated Bottle #‘s: ...... ■... ... ... _70 2. Non Potable 4. Other _. Chain of Custody? vesno " Time/Date Collected: /20/c_ 0^1% Comments: Collected By: ( Agency Code: PWS#: -. < Source ID: Type Descriptor: Collected From: Bill to: Location's/Individual’s Name _ _ /‘.)KL/M Name/Company Street --------—- Street _____ ------- City/StZip __________ --------- _ City/SUZip Identification of Source-.. "_______ D&P __ Phonef Fax#:. Collection Point 8 1 55 -29/44-- CA,CHBI? Check#: Amounts -------------------------------- BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID AN Lab#: Lab#: ) 277 7 n (circle tests) (circle testa) 2/ - ( 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 1. Trihalomethanes (524) /^Volatile Halocarbons (524) 3.) Volatile Aromatics (524) / 1. Purgeable Halocarbons* (624/826C 4 2. Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) / r 3. Coliform MPN (priv well, raw, stp) 4. Fecal Coliform (all samples) 4. Total Trihalomethane Potential (510) 4. Phthalates (625/8270) 3 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) - 5. Microscopic 6. Pesticides (507) 6. PCB's (Arochlors) (608/8081) ” : 6. Macroscopic (7) Pesticides/PCB screen (508) 7. Methoprene (616) 2 0 8. PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) (10) Pesticides (525) 8. Herbicides (EPAI978/8151) 9. Pesticides (SMI8/6630) 10. Petroleum Hydrocarbon Scan (310-13) Refrigerated? yes no 11. Carbamate Pesticides (531) 7 11. Glycols Chlorinated:? yes ; : no 12. Glyphosate (547) 12. Acid Extractables (625/8270) 13. Diquat (549) 13. Base Neutral Extractables (625/8270) Free Chlorine Res:. . mg/L 14. Chlorination Disinfection Byproducts (551) 14. GC/MS Semivolatile Unknown Scan Total Chlorine Res: mg/L 15. Haloacetic Acids (552) ‘ 15. Purgeable Halocarbons (DEF) 16. Pesticides (SM18/6630) 16. Purgeable Aromatics (DEF) pH 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pesticides/PCB’s (DEF) — 18. Other: 18. Other ----------—'————— - ---------------- —------ I—— INORGANIC ANALYSIS REQUESTED - Lab#: / 4 / ■ ‘ (circle tests) 1. Color 20. Acidity ' 39. Aluminum 59. Potassium : / 2. Turbidity 21. Alkalinity, as CaCOa <0. 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 25. Cyanide 43. Beryllium 44. Boron 63. Thallium 64. Vanadium 6. BOD (5 day) 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-violatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) / 32. Oil an Grease 51.Copper : 70. Disk Deliverables 14, Solids, Settleable 33. Phenol 52. Iron ' : TCLP (eolids. Suspended 34. Phosphorus Total as P 53.Lead 71 .TCLP-Metals 10. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 36. Sulfates 55 Manganese 72.TCLP-Pesticides 17. Solids, Total Dissolved 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 w .u ...

NYC-WTC_000026783