Chain of custody record, Westchester County Department of Labs

NYC 9/11 Public Portal Document

4^ environmental services sample SUBM«8K>N form IB WrSTCHESTER COUNTY LABORATORIES AND RFSSABCH iWi , 2 Dana Road, Valhalla, New York 10595 . ...... .. NYS-ELAP No, 10108 Form A-70 (rev. 1/96) iilBlIIllJlIlBBIliili Sample Type fcirclp on-)- tliiBlIpiilllllllilll fS; Potable 3. Non-Potable Treated Bottle #’s:. ____ j . - - 2. Non-Potable 4. Other---------------- -- --------------------------- Chain of Custody? yes: no Time/Date Coiiected:_________ 1JL_l_£—i-i------ : Comments:

ft Collected By:

Collected From: Agency Code:: PWS #i, Bill to: Source ID: Type Descriptor:

Location’s/lndividual's Name___ -------------- i... L_..Z<........ .....— Name/Company Street____£2_____ —2.'............................................. ...... - Street

City/SEZip____ - ’ - - ______ _ .Yjy____ Identification of Sourc0_________ _ __ -—:——----- - ---- -- Phone#: Fax #:: ■ P2L'“£* -1*___ —.. .■■J-J-.i— Check#: Amounts

___ __ _________________ BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES ■ Lab #:__________________________ Labs : (circle lesls) jcifcie SesSsi 1. Heterotrophic Plate 1. Trihalomethanes (524) 1, Purgeabie Halocarbons (624/8260) Count (hemodiaiysLs & ail others) /2\ Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coilform P,/A (public .supplies) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) Illi 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) ■ 6. Microextractables (504) 5. Organoc'niorine Pesticides (608/8080) ■ 6.y Pesticides (507) 6. PCB’s (Arochlors) (608/8080) Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) 7.AP; 0 9., Herbicides (515) ' 8. PCB as Decachlorobiphenyl (508A) 8 Other Pesticides (SM-18/6630) 9. Petroleum Hydrocarbon Scan (310-13) 8. Other; _ ______________ _____ Pesticides (525) 10. Glycol.s in Water TT'. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) Z/ Re(riQefated? yes no 12. Glyphosate (547) ^2........................ .......................... ................. Ch!onnated> yes--------- no 13. Diquat (549) 13^*GC/MS Unknown Scan 14, Chlorination Disinfection Byproducts (551)I 14. Purgeable Halocarbons (DEF) r,eeC.o,™n,s: 15. Haioacetic Acids (552) 15. Purgeable Aromatics (DEF) ■ To,.O«„™eRe. L. WC / 16, Other Pesticides (SM-18/6630) 16. Pesticides (DEF) 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB's (Arochlors) (DEF)

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.;V S' -to ’ ' . M,N<«-s',ANiC ANALYSER RronrSTED I .ib-b • . .... V - - , -

■ ....

B 4.3. pH 1. 2. ' Color Turbidity fO. Acidity '^1. Alkalinity, as CaCOc ($2. Bromide 39. Aluminum 40. Antimony 41, Arsenic 6,. Silver 't/vl i Conductivity (Is. Bromate/Chiorate/Chlorrte 42. Barium ^62. Sodium J

■ 5. 6. 7. Corrosivity (temo: _____ "C) BOD (5 day) ' Soluble BOD (5 day) l£4. Chloride (25. Cyanide M Fluoride 43. Beryllium <63. Thallium 64. Vanadium] ;

8. 9. Carbonaceous BOD (5 dav) Chemical Oxygen Demand' j^7. Hardness, Total as CaCOa "Ss. Nitrogen, Ammonia as N CLP ■ --------------------- IB ■ ^Njrogen. Nitrate as N ,,, 4/. Calcium, Ca (1/ V.i.iiiie- ■8. Semi-volatiles: Mi ........................... 69. Pesticides/I 5's 13. Solids. Percent {%) /O !)f-h D.-iivi-i les ■ olids, Settleable IHB ■enol ■W MB itai as P Iron rcEP

tho as lagnesiur langanesi A lercury ■ tolybdeniJ /'■ ickel .b;b.b<'LLLLsbtL8aas?e:fe;ssiLS:Lifi:.

NYC-WTC_000070246