Chain of custody record, Westchester County Labs, undated

NYC 9/11 Public Portal Document

III ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTOHCSTLR COUNTY LABORATORIES AND R? SLARCH 2 Dana Road. Valhalla, New York 10595 1 thohth** Gxy 914)593-5575 NYS-ELAP No. 10108 (me/Date Set: Form A-70 (rev. 1/96)

06%665s0Qs2.P6S%Gr, ACAr J t ’ample Type (circle one): ' - o 123 k 4050 * 7 2 to ,i 6 42, 1 IJ 1. Potable ) 3. Non-Potable Treated Bottle #‘_______________________________ 2.Non-Potable 4. Other____ Chain of Custody?_____ yes_____ no ■ Time/Date Collected: 11702%-.... -rAlTiil.... Comments: } ■ Collected By__ £ ___ Agency Code:___ PWS #: Source ID:__ _... Type Descriptor:___ Collected From: Bill to. 2/ Location’s/Individual’s Name__ 2 N a m e/C ompa n y......... _)s 1 (e 4L20 Street City/StZp__ x/kall27/00 0 /059t Street... ____ ___ City/St/Zip____ Phone#: Fax #: Identification of Source...... if Collection Point __ ( CA, CH, BI? Check#: Amounts

HA: H Ncil ‘Xi AL ANAL /Si 5 ORGANIC POTABLE ANALYSES ( !3 .ANI NONPOARk i SOLUANAA YS s 1 ■ Labimpth Lab #:__ __ _____ _ ______________ ___ _ (circle tests) (circle tests) AT 1. Heterotrophic Plate 1. 1 rihalomethanes (524) 1. Purgeable Halocarbons (624/8260) 12\ Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) J Count (hemodialysis & all others) (3/ Volatile Aromatics (524) ti 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (5 10) 3. Acrolein & Acrylonitrile (624) A. Phthalates (606/8060) t 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic 6 Pesticides (507) . .6. PCB’s (Arochlors) (608/8080) 6. Macroscopic (7} Pesticides/PCB screen (508) : i- thknb* (M i8/6s40, 81*1) 1 7.ARM 8. PCB as Decachlorobiphenyl (508A) . " o* M-dpp(M 1 , - e; MI; 3. Other 9.. Herbicides (515) (1 0) Pesticides (525) 9. Petroleum Hydrocarbon Scan (310-13) . , 10. Glycols in Water. Refrigerated?_____ yes__ :: , 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) Chlorinated?:_____ yes _ .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)

/*FARYttH0t6lD ; . (circle tests) — 1, Color- 20. Acidity 139. Aluminum | 59.\Potassium 2. Turbidity 21. Alkalinity, as CaCOa j 40, Antimony ” । 60. Selenium

4. PH 22. Bromide Conductivity 23. Bromat e/C h lor at e /C h l or it e J 41J Arsenic s ’ 61. Silver ) 62.; Sodium I 424 Barium 4 ■ 5. Corrosivity (temp: _ °C) 24. Chlonde \43. Beryllium * 1 63/Thallium I 64/ Vanadium 6. BOD (5 day) 25. Cyanide 44. Boron 7. Soluble BOD (5 day) 26, Fluoride 45.Cadmium 165 Zinc _ ____ I 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOa 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 13. Solids, Percent (%) |[50]51 Cobalt Copper 31. Nitrogen, Total Kjeldahl as N 32. Oil and Grease - 0 P i ■ P ,1”. ‘1 ' ’. i.v ■ i 4. (5. Sol Sol i i d d s, s, Settl e abl Suspended e - 33 Phenol I 52 53 Iron Lead -"-r MTTCLPanmm i 16. Solids, Total - 36. Sulfates 1 7. Solids, Total Dissolved 34. Phosphorus, I otal as P 54 Magnesium V 35. Phosphorus, Ortho as P e .56. Mercury meen f 55 Manganese ,1 1C1M-‘s / . Bi t . "* atippopue*p 37 Surfactants 19, Other—SA--T---==- 38.U/V254 1 57 Molybdenum 18. Solids. Total Volatile /.I ICPVomt.* 5 GPbNAs J 1 58. Nickel Etet MMMMGe NYC-WTC_000026840