Sample submission form for environmental testing at Westchester County Laboratories and Research, September 2001.
NYC-WTC_000062881–000062886Folder label: “525 X 9/18”
OCR status: ok · source: pdftotext
NYC 9/11 Public Portal Document
ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ster WESTCHESTER COUNTY LABORATORIES AND RESEARCH tv.com 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 Time/Date Set: Form A-70 (rev.1/96)
Sample Type (circle one): ^Potable 3. Non Potable Treated Bottle #’s: 2. Non Potable 4. Other Chain of Custody? __!^ep no
Time/Date Collected; ______ Comments: Collected By: __ Agency Code: PWS #:______ Source ID; .Type Descriptor: Collected From: Bill to: Location’s/lndividual’s Name VcvU Name/Company Street ; Street_______ City/St/Zip __ _________ City/St/Zip Identification Of Source Phone#: Fax#: Collection Point _ CA.CH, Bl? Check#: Amount$
BACTERIOLOGICAL ANALYSIS ORGANIC ORGANIC NONPOTABLE/SOLID ANALYSIS 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) - s 2. Coliform P/A (public supplies) 3. Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) S 3. Coliform MPN (priv well, raw. stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (625/8270) vr 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) ’ 5. Microscopic 6. Pesticides (507) 6. PCB’s (Arochlors) '(608/8081) 6. Macroscopic Pesticides/PCB screen (508) 7. Methoprene (616) 7. API 8. PCB as Decachlorobiphenyl (508A) 8. Herbicides (EPA1978/8151) 8. Other:____________________ 9. Herbicides (515) 9. Pesticides (SM18/6630) 0) Pesticides (525) 10. Petroleum Hydrocarbon Scan (310-13) Refrigerated? yes___ no 11. Carbamate Pesticides (531) 11. Glycols Chlorinated:? \ yes.no 12. Glyphosate (547) 12. Acid Extractables (625/8270) 13. Diquat (549) 13. Base Neutral Extractables (625/8270) Free Chlorine Res; ntg/L 14. (Chlorination Disinfection Byproducts (551) 14. GC/MS Semivolatile Unknown Scaji l 15. Haloacetic Acids (552) 15. Purgeable Halocarbons (DEF) 5' Total Chlorine Res: mg/L 16. Pesticides (SMI 8/6630) 16. Purgeable Aromatics (DEF)^ pH 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pesticides/PCB’s (DEF) 18. Other: 18. Other:__________ vLZ
INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 1. Color 20. Acidity 39. Aluminum 59. Potassium 2. Turbidity 21. 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 f 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*^ 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-violatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50.Cobalt 69.Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil an Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron TCLP 15. Solids, Suspended 34. Phosphorus Total as P 53.Lead 71.TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 72.TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55 Manganese 56. Mercury 73.TCLP-Herbicides 18. Solids, Total Volatile 37. Surfactants 74. TCLP-Volatiles 19. Other:______________ ___ 38. UV254 57 Molybdenum 75.TCLP-BNA’s 58. Nickel
NYC-WTC_000062881
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NYC-WTC_000062760
Sample submission form for Environmental Services Laboratories and Research, dated September 2001.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.998
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071817
Document tracking the transfer and custody of samples received by Westchester County Department of Labs & Research.
11 shared non-person entities · 1 shared topics · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072603
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 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071567
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_000071655
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_000071898
Document tracking the transfer and custody of samples received by Westchester County Department of Labs & Research.
11 shared non-person entities · 1 shared topics · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072522
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
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 · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000025697
Fragmented document page from environmental protection department records containing identification numbers.
11 shared non-person entities · 1 shared topics · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000026055
Record documenting sample transfer and custody for the Westchester County Department of Labs & Research.
11 shared non-person entities · 1 shared topics · similarity 0.994
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071089
Form documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · similarity 0.994
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072080
Document recording the transfer and receipt of environmental samples at the Westchester County laboratory.
11 shared non-person entities · 1 shared topics · similarity 0.994
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