Chain of custody record, Westchester County Lab

NYC 9/11 Public Portal Document

HI ENVIRCNMENTAL SERVICES SAMPLF SUBMISSION FORM WEST CHESI I R cours Y L ARQFATOHIS ANi 1 n ss ARCH 2 Dana Road. Valhalla, New York 10595 Wbsh*C‘oh wAt*s (914) 593-5 75 doctesodssee NYS-ELAP No. 16 Form A-70 (rev. 1796) Time/Date Set:___ ________ _ Sample Type (circle one): 012M104. 1. Potable ) 3. Non-Potable Treated Bott # sC Ie ‘ ‘ Jef _ __ iv) i2424660031023 I 2-Nen Potable 4. Other__ Chain of Custody?..... ..... yes____ _ no' 229/1 ) kot /68 T ime/Date Collected:___/0/_ Collected BvJ .S C OTT..... . _... Agency Code:_... Jo-5.0l Comments:____ ______________ ___ _________ -________________ 1

PWS #i_____ Source ID:............... Type Descriptor: Collected From: , ____ ____ Bill to J. Location's/Individual's NameiC.LE1__ __ . . Name/Company. Street... I0 LAdA . _ys Street ‘ City/StZipALHRd ........... C.. City/StZip____ Identification of Source__. — Phone#...... ....... Fax C ° 11 ect i on Poin t .. _ z y. [ CA, CH, B? Check#:__ Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLJD ANALYSES ,1 ... 1 labe Lab #: I (circle tests) /14* . f 7. ' ” | * / I (circle tests) 1. Heterotrophic Plate 1. Trhalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2X] 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) 7J Pesticides/PCB screen (508) 'X' Herbicides (SM-18/6640; 8151) A7.ARA A 6. Macroscopic

8. Other.____________ 8. PCB as Decachlorobiphenyl (508A) 9, Herbicides (515) 8. Other Pesticides (SM-18/6630) ”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) . Chlorinated7: _ ____ yes_____ no 13 Diquat (549) P) 14. Chlorination Disinfection Byproducts (551) (13/GC/MS Unknown Scan 14. Purgeable Halocarbons (LOEF) 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. Petroletm/Hydrocarbon Scan (310 13) 17. PCB’s (Arochlors) (DEF)

_PH__

140)" Ar. ntt f.Nt*/!D I|. (circle tests) gg 1. Color gs 20. Acidity 39. Aluminum (40, Antimony 59. Potassium 2. T urbidity 21. Alkalinity, as CaCO3 60. Selenium// 4 1 pH 12170 34. Conductivity 22. Bomide 23 Bromate/Chiorate/Chlorite 21 . Arsenic 42. Banum 61. Silver 11 / l ' 62. Sodium t ‘ 5. Corrosivity (temp:__ °C) 24. Chloride (73) Beryllium (63. Thallium r 6. ROD (5 day) 25. Cyanide 1 44. Boron (64. Vanadium 7 Soluble BOD (5 day) 26. Fluoride 45. Cadmium *65. Zinc__ :___ 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 46. Calcium, as CaCOa CLP ' 1 ■ |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 r - Sem velatips 12. T otal Organic Halides 31. Nitrogen, Total Kjeldahl as N (50 Cobalt 69. Pesticides/PCB's 13. Solids, Percent (%) --4*11100 . 00 . : 32. Oil and Grease . 51. Copper 70 - Disk Deliverables 14. Solids, Settleable 33. Phenol 15. Solids, Suspended e 34. Pnosphorus. Total as P 52. Iron 53. Lead e <! TCLP ' 71. TCLP-Metals 16. Sc lids. Total 35. Pnosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55. Manganese t 73 TCLP-Herbicides

(AOter-A— 38.UV254 18 Solids. Total Volatile . 37. Surfactants 56. Mercury /57Molybdenum *58. Nickel - v 74. TCLP-Volatiles 75. TCLP-BNA’s

NYC-WTC_000027415