Chain of custody record, Westchester County Labs, Nov 2001

NYC 9/11 Public Portal Document Illestchester County ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 A IlA2 NYS-ELAP No. 10100 Form A-70 (rev. 1/9c, Time/Date Set: Sample Type (circle one): Potable 3. Non-Potable Treated Non-Potable 4. Other. Time/Date Collected: 805 Collected By Dt'X-ics Agency Code: Collected From: Location's/Individual's NameAMC OXP Street_/1 CWEST LALE City/St/Zip Mesllrilko, Ahl 10575 Identification of Source Colléction Point C.RO brl 1.22-0 Chain of Custody? Comments: PWS # Billto: Name/Company Street City/St/Zip Phone# CA, CН. ВІ? _yes _no 9019, 901/ Source ID Type Descriptor: Fax #: Check#: Amounts BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab# (circie tests) 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 4. Fecal Coliform (all sampies) 5. Microscopic 6. Macroscopic 7. AP: 1 Other: Refrigerated? yes Chiorinated? yes. • по Free Chlorine Res: mg/L Total Chlorine Res: mg/Lh Lab #: (circle lesis) Trihalomethanes (524) Volatile Halocarbons (524) 3./ Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) 5. Microextractables (504) 6. Pesticides (507) 7. Pesticides/PCB screen (508) 8. PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) 10. Pesticides (525) 11. Carbamate Pesticides (531) 12. Glyphosate (547) 13. Diquat (549) 14. Chlorination Disinfection Byproducts (551) 15. Haloacetic Acids (552) 16. Other Pesticides (SM-18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) 1. Purgeable Halocarbons (624/8260) Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) 4.Phthalates (606/8060) 5. Organochlorine Pesticides (608/8080) 6. PCB's (Arochlors) (608/8080) 7. Herbicides (SM-18/6640; 8151) 8. Other Pesticides (SM-18/6630) 9. Petroleum Hydrocarbon Scan (310-13) 10. Glycols in Water 11. Acid Extractables (625/8270) 12. Base Neutral Extractables (625/8270) (13,/GC/MS Unknown Scan 14. Purgeable Halocarbons (DEF) 15. Purgeable Aromatics (DEF) 16. Pesticides (DEF) 17. PCB's (Arochiors) (DEF) рH INORGANIC ANALYSES REQUESTED *Labt: (circle tests) 1. Color 2. Turbidity 3 pH 4. Conductivity Corrosivity (temp: 6. BOD (5 day) Soluble BOD (5 day) 8 Carbonaceous BOD (5 day) 9 Chemical Oxygen Demand 10. Dissolved Oxygen 11. Total Organic Carbon 12. Total Organic Halides 13. Solids, Percent (%) 14. Solids, Settleable Solids, Suspended 16. Solids, Total 17. Solids, Total Dissolved 18. Solids. Total Volatile 19 Other: 20. Acidity 21, Alkalinity, as CaCOs 22. Bromide °C) 23: Bromate/Chlorate/Chlorite 24. Chloride 25. Cyanide 26. Fluoride 27. Hardness, Total as CaCO3 28. Nitrogen, Ammonia as N 29. Nitrogen, Nitrate as N 30. Nitrogen, Nitrite as N 31. Nitrogen, Total Kjeldahl as N 32. Oil and Grease 33. Phenol 34. Phosphorus, Total as P 35. Phosphorus, Ortho as P 36. Sulfates 37. Surfactants 38. UIV254 39. Aluminum (40) Antimony metas 41 Arsenic 42. Barium 43 Beryllium 440 Boron 45. Cadmium 46. Calcium, as CaCOs 47. Calcium, Ca*? 48. Chromium, Total 49. Chromium, Hexavalent (50. Cobalt 51. Copper 52 Iron 53. Lead 54. Magnesium 55: Manganese po. Mercury 57? Molybdenum 58. Nickel 59. Potassium 60. Selenium 61. Silver 62. Sodium 63. Thallium 64. Vanadium 65. Zinc CLP 66. Metals/CN 67. Volatiles 68. Semi-volatiles 69. Pesticides/PCB's 70. Disk Deliverables TCLP 71. TCLP-Metals 72. TCLP-Pesticides 73. TCLP-Herbicides 74. TCLP-Volatiles 75. TCLP-BNA's NYC-WTC_000070822