DEP WTC record index, Oct 2001

NYC 9/11 Public Portal Document m Mssse Menodd s ■ ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM

III ******* Curt- _915935575 WESTCHESTER COUNTY LABORATORIES AND RESEARCH

NY- I APN- Time/DateSet . oro A-/0 (rov. 1h.

F0a/ Ass npje Tyre ( re •: 1. Potable 2.Non-Potable 4.12.92/ Other < •) Non tike MP. 7- / e Bot le #‘s: Mr Chain of Custody? -4"A yes no ' *Y (4

Time/Date Collected: Come ept- ( Collected By: Agrpgy 1 o. PWS #:__________ Source ID: Type Descriptor: Collected From:_ Bill to: Location’s/Individual’s Name__ Name/Company____ I{ Street Street_____________ City/St/Zip_ City/St/Zip__ ______

eCollection MMSMKGAEOm se Identification of Source_______ Phone#: __ —__ | CA, CH. BP _______ Fax #: Point _* ______ _____ Check#:_____ Amount$

RAt . API OC V ANALYi l.s ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab # (circle tests, Ased Lab# “(circle tests) e 1. Heterotrophic Plate 1. Trihalomethanes (524) 11 Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well. raw, stp) 3 Volatile Aromatics (524) ----- a Volatile Halocarbons (524)

4. Total Trihalomethane Potential (510) 2. 3. 4. Purgeable Aromatics (624/8260) Acrolein & Acrylonitrile (624) Phthalates (606/8060) 4. Feral Coliferm (all samples) 5.6. Microscopic Macroscopic ----- ---?) 6.7)5.Microextractables(504)= Pesti Pesti cciiddeses/(507) P CB ottpnce screen (508) ene 6. 5. Organochlorine Pesticides (608/8080) PCB’s (Arochlors) (608/8080)

7.AP--0, 8. Other -8."PCBasDecachlorobipheny(508A) 9. Herbicides (515) "= 7. Herbicides (SM-18/6640; 8151) 8. Other Pesticides (SM-18/6630) ■J. Petroleum Hydrocarbon Scan (310-13)

Refrigerated?_ yes no 10 Pesticides (525) — 1 15 Carbamate Pesticides (531) 10. Glycols in Water 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 (DE F) Free Chlorine Res: ___ _ 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) 1 7. PCB’s (Arochlors) (DEF)

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INORGANIC ANALYSES REQUESTED I ab# (circle tests) 1. Color 20. Acidity 39. Aluminum • 59. Potassium 2. Turbidity 21. Alkalinity, as CaCO3 40. Antimony 60. Selenium 3. pH 22. Bromide 41. Arsenic 61. Silver 4.' Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium Corrosivity (te mp: __ ___ °C) 24. Chloride 43. Beryllium 63. Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium z Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc__ ________ 1 Carbonaceous BOD (5 day) 111 Chemical Oxygen Demand 27. Hardness, Total as CaCOa 28. Nitrogen, Ammonia as N 46. Calcium, as CaCO3 47. Calcium, Ca‘ CLP 66. Metals/CN 10. Dissolved Oxygen 11. Total Organic Carbon 29. Nitrogen, Nitrate as N 30. Nitrogen, Nitrite as N 48. Chromium, Total 49. Chromium, Hexavalent 67, Volatiles 68. Semi-volatiles 12. Total Organic Halides 13. Solids, Percent (%) 32. 011 and Grease 52.Iron-- 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 51. Copper 69. Pesticides/PCB’s 70. Disk Deliverables 14. Solids, Settleable 33 Phenol 9 TCLP~ 15. Solids. Suspended 16. Solids, Total 34. Phosphorus. Total as P 35. Phosphorus, Ortho as P 53. Lead ad 54. Magnesium 71. n.l‘ Mr-tds 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55. Manganese 73. TCLP-Herbicides 18 Solids. Total Volatile 19. Other e 156. Mercury 37 Surfactants 38.UV254 57. Molybdenum 90 4 C 2 Velies , TCI r: RNA’s +58. Nickel s NYC-WTC_000027062