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 VW********** TTY opruaro V*
ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM
III Uestchestar County
Time/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) Cmple Type (circle one): 15 c y w, 4 * ‘ (1 Potable 3. Non-Potable Treated Bottle Ws: W‘0* 16 • "A C "I V s 2. Non-Potable 4. Other_____________ Chain of Custody? .yes no Time/Date Collected:. Iofi (2061 /301 Comments: Collected By: V 4* * Agency Code: _ .Source ID:. .Type Descriptor:. Collected From: Bill to: Location’s/Individual’s Name. Street__________________ _____ > y Name/Company Street__________ “" 1 ■ ? ip
City/St/Zip_______________ City/St/Zip______ Identification of Source DtPlAD* Phone#_ Fax #: & s Collection Point. /0(40 2094z CA, CH, BI? Check#: Amounts,
BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:____________________ Lab#:_________________________ (circle tests) (circle tests) t4 1 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 Trihalomethane 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) a 6. Macroscopic ( Pesticides/PCB screen (508). t 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) Chlonnated?: yes no 13. Diquat (549) 13. GC/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlonne 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) i. pH •__________ 3 E INORGANIC ANALYSES REQUESTED) Labi: (circle tests) 1. Color 2. Turbidity 3. pH 1 3 . _ $
21 Alkalinity, as CaCOs 22. Bromide —&kvnadss 40. Antimony 41. Arsenic 59. Potassium 60. Selenium 61. Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium 5. Corrosivity (temp: O_’C) 24. Chloride 43. Beryllium 63. Thallium 6. BOD (5 day) 2)5. 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 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-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 ISLE I. Solids. Suspended 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals 1 i. 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. UIV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel ** " - . - • _____.__ _ NYC-WTC_000027110
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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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