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Document / 9 pages

Chain of custody record, Westchester County Labs, Nov 2001

Machine-extracted title · confidence 90%

Chain of custody documentation for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000070783–000070791

Folder label: “28662

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Scanned page image, NYC-WTC_000070784
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NYC 9/11 Public Portal Document

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IL RONMENTAL SERVICES SAMPLE SUBMISSION FORM 8TCHESTER COUI^ LABORATORIES AND RESEARCH 2 Dana ReSd.Walhalla, New York 10595 NYS-ELAP@1O8 (914) 593-5575 Time/Date Set: Form A-70 (rev/J/86) ^mple Type (circle one): Gz Potable 3. Non-Potable Treated Boni. rr Z’X.cr '________iiL- 2. Non-Potable 4. Otheu___,____________________ Chain of Custody? .yes .no Time/Date Co^eA Comments: Collected By: Aaencv Code: PWS#:_________ Source ID: Type Descriptor;£S___ Collected From: Bill to: Location's/lndividuars Name. Name/Company ____________ Street__________________ Street__________ City/St/Zip_______________ Citv/St/Zip Identification of Source. Phone»:_ Fax Collection Point I CA, CH. Bl? Check#:

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLIDj MM Lab __________ (drctetesttj' , 'Yg;?', (circtetosts) ' i- 1. Hetprotrophic Plate . Ttihalorinelhanes (524) 1. Purgeable Halocarbons (624/8^6o: C<^nt (hemodialysis & all,others) . m VUUIIIUI (524t~ 2. Purgeable Aromatics'(624|^|^^^^^S 2. Coniform P/A (public supplies) jfnintilo Arei^iatieo (Eai1).-> 3. Acrolein & Aeiyionitril«''(62^''tl^^§^^ 3. Coli\rm MPN .ipriv well, raw. stp) / 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) ' 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organdchlorine Pesticides (60iawi^"/^ 5. Microscopic & Pesticides (507) '6. PCB’s (Arochlors) (608/8080) ^ ?; / 6. Macroscopic 0J2astiejdes/PG8-S6<»aa45Qg)^ 7. Herbicides (SM-18/6640:8151) ' •Y' 7. AP! 8. PCB as Decachlorobiphenyl (5'S8A) 8. Other Pesticides (SM-18/6630) 8. Other:___________________ a Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) PeBttejjjQH^> » 10. Glycols in Water Refrigerated? ,yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) , Chlorinated?: .yes-------- no 13. Diquat (549) GC/MS-Unknown Scair 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine 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)

pH

INORGANIC ANALYSES REQUESTED - Lab#: (J — (circle tests) jj. V 1. Color 20. Acidity Aluminum 59. Potassium 2. T urbidity 21. Alkalinity, as CaCOs '401 Antimony 60. Selenium 3. pH 22. Bromide 41 Arsenic 61.’ Silver 4. Conductivity 23. BromateZChlorate/Chlorite 42.1 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 CaCOs 46. Calcium, as CaCOs 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca*^ 66. Metais/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N ■■48?Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen. Nitrite as N M9. Chromium, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N zSOl Cobalt 69. Pesticides/PCB's 13. Solids. Percent {%) 32. Oil and Grease 51 .iCopper 70. Disk Deliverables 14. Solids. Settleabie 33. Phenol 52.jlron ISLE 15. Solids. Suspended 34. Phosphorus. Total as P <45/ Lead 71. TCLP-Metals 16. Solids. Total 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids. Total Dissolved 36. Sulfates zS5iManganese 73. TCLP-Herbicides W. Solids. Total Volatile 37. Surfactants 56.|Mercury 74. TCLP-Volatiles (19.Other: “Sa 38. UV254 57./Molybdenum 75. TCLP-BNA’S . 58/ Nickel

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NYC-WTC_000070784Source: NYC Law Department, mirrored locally

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NYC-WTC_000070404 · Box DEP Box 61

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

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