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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_000070788
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NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 NYS-ELAP No.10108 Time/Date Set:_________________________ Form A-70 (rev. 1/96) ^mple Type (circle one): Q. Potable 3. Non-Potable Treated

2. Non-Potable 4. Other _ .._K, t t _ Chain of Custody? .yes .no Time/DateCollected^ K _ Comments: Collected By: ♦AoencvCode: _ PWS #:_________ .Source ID:, .Type Descriptor:. Collected From: -5 / Bill to: Locatlon’s/lndivIduars'Name _ Name/Conpany Street____4_______________ __ _ Street________ _ City/St/Zip \ ____________ . City/St/Zip Identification of Source - Phone#:J -Fax#:, Collyriion Point " Basssaua I CA.CH Bl?. Check#: Amounts.

I BACTERIOLOGICAL ANALYSES ORGANIC POTABL| ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES ./ Lab#:_i_jiiYiH\L^&^^ ■ (<*<* Y' V' ■ (eircteteste)?-/, l' Purgeable Halocarbons (624/8& ‘' • 1; Heterotrophic Plate . ;Y 1. Trihalomethanes (524) Count {hernod1a!ysls & all Others) W) 2. Purgeable Aromatics (624/8260) /! 2. Coliform P/A (public supplies) 3. Acrolein & Acrylonitrile (624) W 3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochiorine Pesticides (608/8080) - 5. Microscopic.) , Pesticides (507) ‘6. PCB’s (Arochlors) (608/8080) 6. ^crosco^V^g^^ ■ ResHeidewWB^ TtseeK 7. Herbicides (SM-18/6640; 8151) W 8. PCB as Decachlorobiphenyl (SOSA) 8. Other Pesticides (SM-18/6630) r W .’ 8. Other: "'F-’Y/P'• Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) . ■ Pailli&TUua'(SgD) ■■ 10. Glycols in Water Refrigerated? yes no ‘ 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) ;- 12. Glyphosate (547) IjL Base Neutral Extractables (625/8270) Chlonnated?: ves no ;.13. Diquat (549) ^^GC/MS Unknown Scan h14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine Res:. .mg/L -15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) ’ 16. Other Pesticidos (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 REQUESI^b liab# (circle tests) -j .f >, 1. Color ^^Aldity BS^AIuminum SSkPotassium 2. Turbidity 'gf; Alkalinity, as CaCOa MO.Untimony /^O.^elenium 3. pH ^^niide Ui .Arsenic \6ySilver 4. Conductivity 23; Bmmate/Chlorate/Chlorite l/^Barium Sodium 5. Corrosivity (temp: .°C) 2^, CBioride *^^eryllium ( 33: Thallium 6. BOD (5 day) •2< CYpnide 44. Boron 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 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N Calcium, Ca*’ 66. Metals/CN "^10. Dissolved Oxygen 29. Nitrogen, Nitrate as N US.-'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 feoi Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 51\ Copper 70. Disk Deliverables 14. Solids. Settleable 33. Phenol 524 Iron ISLE 15. Solids, Suspended 34. Phosphorus. Total as P Lead 71. TCLP-Metals 16. Solids, Total 35. Phosphorus. Ortho as P Magnesium 72. TCLP-Pesticidos 17. Solids, Total Dissolved 36. Sulfates '-nganese 73. TCLP-Herbicides Solids. Tot^olatile 37. Surfactants ircury 74. TCLP-Volatiles Af^ther: 38. IIV254 lolybdenum 75. TCLP-BNA’s ickel

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NYC-WTC_000070788Source: 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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