Westchester County Department of Labs and Research chain of custody form documenting the transfer of environmental samples.
NYC-WTC_000027107–000027114Folder label: “24046”
OCR status: ok · source: pdftotext
NYC 9/11 Public Portal Document 25555* *=wnnorW ••
ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM . 7 () ( II WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 m) aTime/Date Set: ____________ _ Form A-70 (rev. 1/96) Cmple Type (circleone): 8*7: • Fy. < . , ' s - 7{)% -s Quotable 3. Non-Potable Treated Bottle #‘s: *5*o • 35244 7r f - j /, ■ 7* 5 - . r/s 2. Non-Potable 4. Other Chain of Custody? _ .yes .no Time/Date Collected: ___________________ __ Comments: Collected By: •* Agency Code: PWS#:_________ .Source ID:. .Type Descriptor:. Collected From: BUI to: Location’s/Individual’s Name. Nitlye rW ose ver. Name/Company Street_____________ ___ Street__________ _ City/St/Zip Identification of Source____ Phone#:_ Fax #: Collection Point BY3 CA, CH, Bl? Check#: < Amounts. V
BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:_____________________ Lab #:____________________________ (circle tests) (circle tests) 1. Heterotrophic Plate 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) • Count (hemodialysis & all others) 2.] Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) 3: Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) 4. Total Trihaiomethane Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic 6. .Pesticides (507) 6. PCB's (Arochlors) (608/8080) 4 6. Macroscopic .) Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) 7. API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) .8. Other: 9 Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) (10. Pesticides (525) 10. Glycols in Water “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 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chiorine Res:. mg 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 M •. m ( nt
INORGANIC ANALYSES REQUESTEDLab#: (circle tests) 1. Color 1 P A : 4 t*h 20. Acidity — •• hea/s 59. Potassium .2. Turbidity 2f 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 CaCOs 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 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 B Solids. Suspended 34. Phosphorus, Total as P 53. Lead 71.TCLP-Metals ) D. 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
NYC-WTC_000027109
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NYC-WTC_000026945
Westchester County Department of Labs and Research chain of custody form for environmental samples submitted by the City DEP.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.998
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027437
Document tracking the custody and handling of environmental samples submitted to the laboratory.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.997
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027723
Document tracking the transfer of environmental samples to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000026447
Document tracking the chain of custody for environmental samples submitted to the Westchester County Department of Labs & Research.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000026864
Westchester County Department of Labs and Research chain of custody form for environmental samples submitted by the City DEP.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027271
Document tracking the custody and handling of environmental samples submitted to the laboratory.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027641
Document tracking the transfer of environmental samples to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000026432
Record documenting sample transfer and custody for environmental testing at the Westchester County Department of Labs & Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027804
Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071530
Form tracking samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000070569
Chain of custody documentation for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072362
Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · similarity 0.995
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