Chain of custody record, Westchester County Labs, Nov 2001

NYC 9/11 Public Portal Document

HL UtesfchBitwtounty ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914)593-5575 --- - s NYS-ELAP No. 10108 ■ Form*-7°lre». 1/961 Time/Date Set: _____________________ Sample Type (circle one): Bottle #’3: “ " 1792. & ______________ l7>Potable 3. Non-Potable Treated 2. Non-Potable 4. Other Chain of Custody?. .yss no Time/Date Collected;_______~ f •’ J Ax.' Comments; Collected By: I > ■ • t/' V ' A Agency Code: PWS #:_________ _Source ID:. .Type Descriptor:. Collected From: Bill to; Location's/lndiyidual’s Name. Name/Companv Street____________ ___ Street__________ City/SVZip_________ City/St/Zip___ Identification of Source Phone#; Fax #:. Collection Point__ fg?/ .3 | CA.CH Bl? .Check#: Amounts.^

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES . ORGANIC NONPOTABLE/SpLID ANALYSES Lab#:__________ ja-________ Lab (drcls tests) (circle tests) . 1. Heterotrophic Plate V Trihalbmethanes (524) 1. Purgeable HaIocarbons (624/8260) 2. Purgeafale Arpmatics.(62'^2iSp) Count (hemodialysis & all others) 2. Coliform P/A (public supplies) S' Volatile Halocarbons (524) Volatile Aromatics (524) 3., . Acrolein & Acrylonitrile (624) v ? , » Siti;

3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (510) - : 4. Phthalates (606/8060) \ i 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic 6. Pesticides (507) 'e. PCB’s (Arochlors) (608/8080) 6. Macroscopic Pesticides/PCB screen (508) 7.' Herbicides (SM-18/6640::fi’fe) 7. API K PCB as Decachlorobiphenyl (508A) • Bfl. other Pesticides (SM-18/6p’3O) 8. Other:___________________ 9,-x Herbicides (515) • 9. Petroleum Hydrocarbon ScSn'(310-13) QjX Pesticides (525) 10. Glycols in Water /. , Y Refrigerated? yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) Base Neutral Extractablqs (625/8270) Chlorinated?: .yes. no 13. Diquat (549) GC/MS, Unknown Scan : 1 ; 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) I . ' Free Chlorine Res:. .mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) I 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)

pH if INORGANIC ANALYSES REQUESTED - Lab#: { "7 (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. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOa 46. Calcium, as CaCOa £LP 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. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron ISLE 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 73. TCLP-Herbicides 18. Solids. Total Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles 19. Other:_____________ 38. I.IV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel

NYC-WTC_000070576