Chain of custody record, Westchester County Lab, Oct 2001

NYC 9/11 Public Portal Document *** 5 MMAAdaatnot ■■ MH ik ENVIRONMENTAL SERVICES SAMPLE SUCMISSION FORM WESTCHESTER COUNTY LABPRATOMES ANP RI'S ’ARCH 2

e Uestchester County Valhal a, New York.10595ati 112 Dana Road,914593-5575 NY: ANo ’ Time/DateSetA r onn a / (rev. Sample Tvpe (circle one) d SCWREMEG@RMsot 11, Potable 3. Non-Potable Treated_ ms&C AO 020 1372gTR03717102060 12.Non-Potable4Other= Chai n meof Custody? Comments:_=I — - sasiGrsdmYe---no ------ or asatemes Time/Date Col ected: ORS5O-2 07 Col ected ByDLGTOAgency Code: . iw i . _Source ID:_ 1 2* l' a rpror Col ected From_ s Location’s/Individual’s Name___ _____ Name/Company_____ Street ULU h laua Pouls Street City/StZip___ . HleA Y 50 City/StZip identification of Source.,.. r nole#._________ Fax #: Collection Point. /_ | CA, CH, BI?.. Check#: Amounts

C AS i'. dOLudlAt ANALYStS ORANiO 2 TAP* :. ANA' Y-T S ORGANC NONPO[ABU!/S(C ANALYSES Lab#:____ __ _ ___________ (circle tests) — VVVaa= Lab# 1. Heterotrophic Plate (ci1. rcleTrihalomethanes tests) 0-(524) — । : coable ! Inor rhens (4 2’80) " ‘ Count (hemodialysis & all others) .2A Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) ( 2. Coliform P/A (public supplies) ‘3, Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3.5 i :MNu.# iell, :w tp) 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5 i • : ios Hone Hestcides (6:08/8080) 5. Microscopic—y 6. Pesticides (507) G 0— s (Ai-x hr : (8113/8080) 6. Macroscopic ----- Z.ARL (7.) Pesticides/PCB screen (508) 87 PCB as Decachlorobiphenyl (508A) 7. Herbicides (SM-18/6640; 8151) 8. oral Pesticides (SM 13/5530) 8. Other e 9,i Herbicides (515) . : •’ olcum l lydroczlion .'.'■■.-.in (310-13)

Refrigerated?_____ yes no (10 Pesticides (525) 11. Carbamate Pesticides (531) ma 10. Glycols in Water t1 ,** r xiraztohl" (G: "5/2 ) 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270). . Chionnated”: yes !1.) . 13. Diquat (549) 13. GC/MS Unknown Scan 1.4. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine Res: mg/L . 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF)

Total Chlorine Res: mu'l. 16. Other Pesticides (SM-18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) 16. Pesticides (DEF) (ta 17. PCB’s (Arochlors) (DEF)

PH___

INORGANIC ANALYSES REQUESTED Lab#__ (circle tests) 1. Color * . <■ ■ 20. Acidity J— —55 39-Aluminum IMOO] 59. Potassium I 2. Turbidity 21: Alkalinity, as CaCOa C 40. Antimony 3pH_ 4. Conductivity 22. Bromide 41. Arsenic 60. Selenium 61. Silver * : 23. Bromate/Chlorate/Chlorite 42. Barium 62.Sodium 5. Corrosivity (temp: °C) 24. Chloride (43 Beryllium (63. Thallium i 6. BOD (5 day) 7. Soluble BOD (5 day) B. Carbonaceous BOD (5 day) 25; Cyanide 26. Fluoride 27. Hardness, Total as CaCO3 44. Boron . 45. Cadmium 46. Calcium, as CaCOa (64 Vanadium 65. Zinc____________ CLP A 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca*2 " ' os MeiaN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N 48. Chromium, Total 67. Volatiles i 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 C50.Cobalt 6J Posin ub's/PCB's . 13. Solids, Percent (%) 2 Oli and Gi ■ no 51. Copper iet 52.tron---" 70 iVkC’bvc. i! es 14. Solids, Settleable 15. Solids, Suspended , 33 Phenol r. 53. Lead —-5 34. Phosphorus. Total as P TCLP 71. 1r MAsa 16. Sclids, Total 35. Phosphorus, Ortho as P 54. Magnesium 72 '<11 P . ide 3 17. Solids, Total Dissolved 36. Sulfates 37. Surfactants 55. Manganese y 9 56, Mercury /3, .Ci R l tala .■'ins i C19 Other S 18. Solids, Total Volatile " * is ‘ v2- (57. Molybdenum 58. Nickel Es / FClYoia /5 ;C1.2 NA

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