Chain of custody record, Westchester County Labs, Nov 2001

NYC 9/11 Public Portal Document

J!L ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Oana Road. Valhalla, New York 10595 (914) 593-5575 IS NYS-ELAP No. 10108 Time/Date Set:_________ Form A-70 (rev. 1/96) Sample Type (circle one): T2>otable 3. Non-Potable Treated Bottle -//</

2. Non-Potable 4. Other.____________ _ Chain of Custody?. Yes .no ■■ \ 1

Time/Date Collected: j . Comments: Collected By: w i L .Agency Code: . PWS #: .Source ID:. .Type Descriptor:. Collected From: . Bill to: Location’s/lndividual’s Name _ Name/Company Street ________ __ . Street Citv/SVZiD City/St/Zip^_______ Identification d Source. Phone#: .,Fax#:x Collection Point . I CA. GH Bl? Check#:, Amounts,

ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES <1 ah '(drcletesis) ’ ; .p.' " ' Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all bthers) Volatile Halocarbons (524) Y' 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) . Volatile Arorhetics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) Total Trihalomethane Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic 6. Pesticides (507) 6. PCB’s (Arochlors) (608/8080) 6. Macroscopic 7. Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) 7. API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) 8. Other:________ __ _______ .1 9. Herbicides (515) 9 Petroleum Hydrocarbon Scan (310-13) 10. Pesticides (525) 10. Glycols in Water Refrigerated? yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) t2^ase Neutral Extractables (625/8270) Chlonnated?: yes no 13. Diquat (549) Xs^GC/MS-Unknown Scan .'14. Chlorination Disinfection Byproducts (551) tC Purgeable Halocarbons (DEF) Free Chlorine Res:, .rng/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) 16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) Total Chlorine Res: .mg/L X- ; 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF)

••W _______________________ INORGANIC ANALYSES REQUES-^p yLab#: 7 \ < Kt (circle tests) j}- c- O L/ U' 1. Color Attidity Aluminum. Potassium 2. Turbidity 2|. Adcalinity, as CaCOs Antimony Selenium 3. pH •22. Bromide I 41 Arsenic Silver 4. Conductivity 23. Bmmate/Chiorate/Chlorite 1 42. Barium 62. Sodium 5. Corrosivity (temp: ’C) 24. Chloride IjW Beryllium (2^. Thallium 6. BOD (5 day) •25. Cyanide 44. Boron Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 1 65/ Zinc 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOs 46. Calcium,, as CaCOs fiLE 9. Chemical Oxygen Demand 28. Nitrogen. Ammonia as N ^Calcium, Ca*’ 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N Z48)Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N Chromium, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N ZSa Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 511 Copper 70. Disk Deliverables 14. Solids. Settieable 33. Phenol 52.|lron TCLP 15. Solids. Suspended 34. Phosphorus. Total as P L^Lead 71. TCLP-Melals 16. Solids. Total 35. Phosphorus, Ortho as P S4- Magnesium 72. TCLP-Pesticides r- 17. Solids. Total Dissolved 36. Sulfates Manganese 73. TCLP-Herbicides

4 Solids, 1^1 Volatile Other IS 37. Surfactants 38.1.IV254 I 561Mercury I 57JMolybdenum k sat Nickel 74. TCLP-Volatiles 75. TCLP-BNA’s

NYC-WTC_000b76789