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Chain of custody record, Westchester County Department of Labs

Machine-extracted title · confidence 95%

Record documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000070477–000070480

Folder label: “27764

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NYC 9/11 Public Portal Document Westchester County ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 Time/Date Set: Sample Type (circle one): 1) Potable 3. Non-Potable Treated 2. Non-Potable 4. Other Time/Date Collected: 1500 11-10-61 Collected By: Wagner Agency Code: Collected From: Location's/Individua's Name_ NYC DEP Street 11 WesiLeke DRIuC City/St/Zip_ Volhallo, Ny 10373 Identification of Source Collection Point C20 CH ZSArE eeste Bottle #'s: 6 Chain of Custody? yes comments: PWS#:_ Source ID Bil to: Name/Company Street City/St/Zip Phone#: CA, CH. BI? BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES Lab#: (circle tests) 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 4. Fecal Coliform (all samples) 5. Microscopic 6. Macroscopic 7AРL 8 Other: Refrigerated? Ves no Chiorinated.. Kyes Free Chlorine Res: _mg/L Total Chlorine Res: mg/L Lab #: (circle tests) 1. Trihalomethanes (524) Volatile Halocarbons (524) Volatile Aromatics (524) Total Trihalomethane Potential (510) 5. Microextractables (504) Pesticides (507) Pesticides/PCB screen (508) 8. PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) 10 Pesticides (525) 11. Carbamate Pesticides (531) 12. Glyphosate (547) 13. Diquat (549) 14. Chlorination Disinfection Byproducts (551) 15. Haloacetic Acids (552) 16. Other Pesticides (SM-18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) pH INORGANIC ANALYSES REQUESTED- Lab#: (circle tests) 1. Color Turbidity pH 4. Conductivity 5 Corrosivity (temp: °C) 6 BOD (5 day) 7 Soluble BOD (5 day) 8 Carbonaceous BOD (5 day) 9. Chemical Oxygen Demand 10. Dissolved Oxygen 11. Total Organic Carbon 12. Total Organic Halides 13. Solids, Percent (%) 14. Solids, Settleable 15. Solids, Suspended 16. Solids, Total 17. Solids, Total Dissolved 18, Solids Total Volatile 19. Other: 20. Acidity 21: Alkalinity, as CaCO, 22, Bromide 23. Bromate/Chlorate/Chlorite 24, Chioride 25. Cyanide 26. Fluoride 27. Hardness, Total as CaCO, 28. Nitrogen, Ammonia as N 29. Nitrogen, Nitrate as N 30. Nitrogen, Nitrite as N 31, Nitrogen, Total Kjeldahl as N 32. Oil and Grease 33. Phenol 34. Phosphorus, Total as P 35. Phosphorus, Ortho as P 36, Sulfates e7 Surfactants 381JV254 39. Aluminum 40, Antimony 41. Arsenic 42. Barium 43 44 Beryllium Boron 45 Cadmium 46. Calcium, as CaCOs 47. Calcium Ca*2 48. Chromium, Total 49, Chromium, Hexavalent L50/ Cobalt 51. Copper 52, Iron 53 l ead 54, Magnesium 55, Manganese 56. Mercury 57 Molybdenum 58. Nickel NYC-WTC_000070480 NYS-ELAP No. 10108 Form A-70 (rev. 1/96) X7 и 572 Type Descriptor: Fax #: Check#: Amounts ORGANIC NONPOTABLE/SOLID ANALYSES 1. Purgeable Halocarbons (624/8260) 2. Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) 4. Phthalates (606/8060) 5. Organochlorine Pesticides (608/8080) 6. PCB's (Arochlors) (608/8080) 7. Herbicides (SM-18/6640; 8151) 8. Other Pesticides (SM-18/6630) 9. Petroleum Hydrocarbon Scan (310-13) 10. Glycols in Water 11. Acid Extractables (625/8270) 12 Base Neutral Extractables (625/8270) 13 GC/MS Unknown Scan 14. Purgeable Halocarbons (DEF) 15. Purgeable Aromatics (DEF) 16. Pesticides (DEF) 17, PCB's (Arochlors) (DEF) metas 59. Potassium 60. Selenium 61. Silver 62. Sodium 63. Thallium 64/ Vanadium 65. Zinc CLP 66. Metals/CN 67. Volatiles 68. Semi-volatiles 69. Pesticides/PCB's 70. Disk Deliverables TCLP 71. TCLP-Metals 72. TCLP-Pesticides 73. TCLP-Herbicides 74, TCLP Volatiles 75 TCLP BNA'S

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NYC-WTC_000070480Source: NYC Law Department, mirrored locally

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