Chain of custody record, Westchester County Department of Labs

NYC 9/11 Public Portal Document '1

111 .. .......................... ................................................................................ WESTCHESTER COUNTY LABORATORIES AND RESEARCH E gWJ j f 2 Dana R.-.1-:. Vr/hYto n,-..-. Vr-i.- UtestehBstorCeuW (914) 593-5S75 c ' NYSYLAP No. 10108 Time/Date Set: Form A-70 (rev. 1/96) Sample Type (circle one): ■ ■IB ■iiii ■ i A" . k: ■ IIB lllllllllillllllilillill 1Potable 3. Non-Potable Treated Bottle t t ■ ■ -

2. Non-Potabie ' '4. Other : .. Chain of Custody?yes: no Time/Date Collected:'r S. t/-f - t.f__________ Comments:i

Collected By:_ L_-iCL_14__-!C_________ Agency Code:J . PC'S #;: Source ID: Type Descriptor: Colto'-tcd Fiom: pn;to- Location's/lndividual's Name__ LU..i____ ii__ ri..... ...... ..... . Name/Company^ Street, - !_ _2._;__ LJJLLX______ ■ ' _______ _ _____ J ... Street__________ City/St/Zip i iBSBlHia8SilSlkBSBi|8i|lll»liii|iiWWTkkii|k|iSB^^^ Phone#: Fax #(: ICA.CKhii" Check#: : Collection Poir' _ ______ ___________ Amounts i ■

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ~ ORGANIC NONPOTABLE/SOLiD^ANALY^

Lab#:____ __ __ ___ ____________ Lab it: i (circle tests) icircip lesis) 1. Heterotrophic Plate 1. Trihalomethanes (524) IB Purgeable He' ’ Count (hemodialysis & all others) •'■JL Volatile Halocarbons (524) 2. Purgeabic Aromatics (624/8260) 2. Coliform P/A (public supplies) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) 4. Total Tnhaiomethane Potential (510) z................... (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic 6. Macroscopic 7. API I■ 8. Otber:„_ ___ _________ _ i a “XX“2”’,3io. I Pe-.K-i C- f-rc m C v ■ hinW.tor Refrigerat- '? v-s ...no Vf. Carbamate Pesticides (531) 11. Acid Extractabies (625/8270)

■ 12. Glyphosate (547) 12.,Base Neutral Extractabies (625/827C Chlor,natedY

Free Chlorine Res:i...mg/L. yes J no ■ 13. Diquat (549) 14. Chlorination Disinfection Byproducts (551) 15. Kaloacofc Acids (552) <iy3C'^^S Unknown Scan 1^, Puraeabie Halocarbons (DEF) 15. Puraeabie Aromatics (DEF) 16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) Total Chlorine Res:: mg/L 17. PetroleunVHyd-'ocarbon Scan (310-13) 17. PCB's (Arochlors) (DEF) 11

Pii ......... .......... ............... ' . ..7-"' P ■2zZ__ . H ___________ ..... INORGANIC ANALYSES REQUESTED - Lab#: h ......... (circle tests).. .... .............. .. .... 1. Coiori 2.. Turbidity 20. Acidity ' 39. Aluminum htakSkSWBSafigi'i 21. Alkalinity, as CaCOs 40y Antimony 60. Selenium . 22. Bromide 41. Arsenic 6,. seer 4. Conductivitv 23. Bromale/Chlorate/Chlorite’ 42. Efariurn 5 Corrosivity (femp: 1 .’C) 24. Chloride 43. Berylhum '44. Boron k Site Si (5 day) £ FtoS 4S. Cadmium e. Carbonaceous BOD (5 day) 9. Chemical Oxygen Demand 10. Dissolved Oxygen 27. Hardness, Total as CaCO. 28. Nitrogen, Ammonia as N 29. Nitrogen, Nitrate as N 46. Calcium, as CaCOa 4p Calcium, Ca*^ 46. Chromium, Total ctr 66. Metals/CN 6/ Volatile.' Ml 49. Chromium, Hexavalent 68. Semi-votatiies ■ 69. Pesficirivs/PCB's Zn. Di' k DciiVer;:;)!,-: i3. Phen^c-i ICLP losphorus. i c >lal as I .ead 1R "d T fJ iosphorus, Oi 'tho as ^agnesiumS fl Kates ^angartese: riactantsl TIercury ■ eri ■■i

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