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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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NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM UtejUHLty WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. .10108 Time/Date Set: __________________________ Form A-70 (rev. 1/96) SaroPleTyjpe (circle one): 'l, Potabl^^ 3. Non-Potable Treated Bottle #’s:<^* ^7 <3^ ( ■Y'TIorbPS^Ie 4. Other __________ Chain of Custody? Y®s .no Time/Date'Collected: fl ' 6gAw II 1^0 > Comments: Collected By: . Aoenev Code:. PWS#;________ .Source ID:. .Type Descriptor. Collected From: Bill to: Location’s/lndivldual’s Name_ Name/Company Street ______________ Street_________ Oity/St/Zp,^________ _ City/St/Zip_____ _ Identification of Source. Phone»:_ Fax#:. Collection Point I CA. CH. Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLIDANALYSES Lab#-:La_ai^Si>- Lab#: ; (circletests) .. (circle tests) .. . : 1, Hpterdtrophic Plate y" Y 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260pfc count (hemodfa!ysis' & all'others) 2. Purgeable Aromatics (624i?^) ^?W > 2. Coliform P/A public supplies) ■3/ vuraina’ATOi'fuiiLj (sp <) 3. Acrolein & Acrylonitrile (624) ; 3. Coliform MPN (priv well, raw. stp) 4. Total Trihalomethahe Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (ail samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) - 5. Microscopic 6. Pesticides (507) '6. PCB’s (Arochlors) (608/8080) 6. Macroscopic ^Pesfaidois/PODTOToun (GOS) 7. Herbicides (SM-18/6640; 8151) 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) 8. Oler: a Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) @ ProtiLidos (OPC) 10. Glycols in Water RefriSrated? yes •- no . n. Carbamate Pesticides (531) 11. Acid Ext/actables (625/8270) 12. Glyphosate (547) ^.^ase Neutral Extractables (625/8270). OhlonnWd?: \ ves no ; 13. Diquat (549) ^sJgC/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) 14 Purgeable Halocarbons (DEF) Free Chlonne Res:, .fng/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) I?. pH SSB

INORGANIC ANALYSES REQUESTED &ab#:. pl, ta (circle tests) ■ 1. Color ^^»^luminum 59. Potassium 2. Turbidity . 2K/^alinity, as CaCOs 140. Antimony r^OjSelenium 3- pH . ■ Brnmido 141. Arsenic Wsilver 4. Conductivity SS. B^mate/Chlorate/Chlorito l42. Barium 62. Sodium 5. Corrosivity (temp: ’C) 2>CJj|pride ^)<g^eryllium '63?;Thallium 6. BOD (5 day) 25. Cyanide 44. Boron §4. 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 CaCOs ctE 9. .Chemical Oxygen Demand 28. Nitrogen, Ammonia as N ^Calcium, Ca*’ 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N Chromium. Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N Jg. Chromium, Hexavalent 68. Semi-volatiles 12. Total Oi lie Halides 31. Nitrogen, Total Kjeldahl as N /goXobalt 69. Pesticides/PCB’s 13. Solids, I (%) 32. Oil and Grease 151. Copper 70. Disk Deliverables 14. Solids. J Ie 33, Phenol j 52. Iron ISLE 15. Solids, Si inded 34, Phosphorus. Total as P <5^ead 71. TCLP-Metals 16. Solids. T( ®iosphorus. Ortho as P Magnesium 72. TCLP-Pesticidos 17. Solids. T Dissd|e^ ' ' gl^imtfates ^^Manganese 73. TCLP-Herbicides l^Solids. Total Vol^ '37. Surfactants 56.|Mercury 74. TCLP-Volatiles b^lV254 |57.iMolybdenum 75. TCLP-BNA's ^8/Nickel

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NYC-WTC_000070787Source: 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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