Chain of custody record, Westchester County Department of Labs

NYC 9/11 Public Portal Document

IL ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNT\|LABORATORIES AND RESEARCH 2 Dana Roadwalhalla, New York 10595 114)593-5575 NYS-ELAP No. 10108 Time/Date Set:___________ C - "1 Form A-70 (rev. 1/96) Sample Type (circle one); 1. Potable 3, Non-Potable Treated 2. Non-Potable 4. Oth^r__________________ Chain of Custody? .yes .no I Time/Date Colla«ited: ~ ' Comments:_____ Collected Bv: / ■ 6 jy-yAn .Agency Code:, PWS#:. Source ID:, Typ9 Descriptor:. Collected From: ji Bill to: ✓ Location’s/lnd'ividuars Name /> __ Namo/Company Street_____________ _u Street___12_ Citv/SVZiD 'i City/St/Zip^ Identification of Sourco__ — Phone#:,. ' Fax#: • Collection Point I CACH, Bl? Check#:. ; Amounts.

BACTERIOLOGICAL ANALYSES j ORGANlC^T^j^ANALYSES ; j|ORGANIC NONPOTABLE/SOLIDANALYSES I ah#: ■• . .4 (circle teste). ’' ■S 1. Heterotrophic Plate.. jFrihaldmethaniis (524) ' < - 1. Purgeable Halocarbons (624/8260) > Count (herhodialyj^ & aH others) IVolatileHalbcarbons (524) ‘ 2. Purgeable Aromatic^ (624/82^) • - C p 2. Coliform P'/A (publB supples) . Volatile Arombtics (524) ; ' 3.. Acrolein 4 Acrylonitrile (624) H v 3. Coliform MPN (priv well, raw, stp) 4.’Total Trihalomethaine Potential (510) 4. Phthalates (606/806p) " ’ \ 'fc 4. Fecal Coliform (all samples) 5. Microextractables (504) . 5. Organochiorine Pesticides (608/8080) 5. Microscopic 6. Pesticides (50?) . ■??' k PCB’s (Arochlors) (608/^80) A ' 6. Macroscopic . Pesticides/PCB screen (508) , ;. /. - 7. Herbicides (SM-18/6640; 815.1). 7. API i.-/ 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) f 8. Other:________________ ^ Herbicides (515p 9. Petroleum Hydrocarbon Scan (310-13) •; 53 Pesticides (525) ■ f 10. Glycols in Water • -r- Refrigerated? yes no 11. Carbamate Pesticides (531 )\ j 11. Acid Extractables (625/8270) 12. Glyphosate (547) , ;2. Base Neutral Extractables (625/8270) "► Chlorinated?: .yes_____ no 13. Diquat (549)’ 53 GC/MS Unknown Scan . 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlonne 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)

soBsata z •P" INORGANIC ANALYSES REQUESTED - Lab«:. (circle tests) 1. Color 20. Acidity 39. Aluminum 59. Potassium 2. Turbidity 21. Alkalinity, as CaCOa 40. Antimony 60. Selenium 3. pH 22. Bromide 41. Arsenic 61 ..Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium 5. Corrosivity (temp:. °C) 24. Chloride 43. Beryllium 63. Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanaoium 7. Soluble BOD (5 day) . 26. Fluoride I 45. Cadmium 65. Zinc _________ 8. Carbonaceous BOD (5 d^) 27. Hardness, Total as CaCOs 46. Calcium, as CaCOa £LE 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-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pestieides/PCB's 13. Solids, Percent (%) .j 32. Oil and Grease 51. Copper 70. Disk Deiiverables 14. Solids, Settleable 33. Phenol 52. Iron ISLE 15. Solids. Suspended 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals 16. Solids. Total .I 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids. Total Dissolved I 36.SulfatM\, 55. Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile .j^ 37. Surfactants . 56. Mercury 74. TCLP-Volatiles 19. Other:_____________ 57. Molybdenum 75. TCLP-BNA’s 58. Nickel

NYC-WTC_000070466