Chain of custody record, Westchester County Lab, Oct 2001

NYC 9/11 Public Portal Document

101 ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 Time/Date Set:_________ Form A-70 (rev. 1/96) Sple Type (circle one): 1. Potable te 3. Non-Potable Treated Bottle is: (9753, ‘/-r. 257, 56, ‘st /‘S 29% 2. Non-Potable 4. Other______ _ _______ Chain of Custody?_____yes no /720509294 'Time/Date Collected: AS An ///P Comments:_____________ Collected By 2, Gerrnc Agency Code: _ Source ID: Type Descriptor. Collected From: Bill to: Location’s/Individual’s Name________________ ____ —. Name/Company. Street._______ __ ____________________________ __ - Street________ _ ____________ ; Identification erf Source________________ ___________ Phone#:, -Fax #: Collection Point 2032 (A*AEP) CA, CH, Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES _ ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:________________ ___ Lab#: _____ 2 L (circle tests) ! . ] 7/ (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 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) 6. Macroscopic (7) 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 erated? yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) < 12. Glyphosate (547) e 12. Base Neutral Extractables (625/8270) Chlorinated?: yes no 13. Diquat (549) “ 13. GC/MS Unknak.Scan $ i 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chionne 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)

pH s INORGANIC ANALYSES REQUESTED ZLab#: (circle tests) 1. Color 4 2d. Acidity 39. Aluminum * 7 EArS 59. Potassium 2. T urbidity 21. Alkalinity, as CaCOs 40. Antimony 60. Selenium 52 3. pH 22. Bromide 41. Arsenic 61. Silver 1 — La 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium ,A 5. Corrosivity (temp: °C) 24. Chloride 43. Beryllium 63. Thallium ' l/ 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc i______________ 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 87. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Gnromium, 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 1@olids, Suspended 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals 1wrolids. Total 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55. Manganese 73. TCLP-Herbicides a 18. Solids. Total Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles• 19. Other:_____________ 38. 1IV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel ---=-=------====--==--==A==-= —=====--======= _kocasdcdcodm==i=d NYC-WTC_000027193