Chain of custody record, Westchester County Lab, Nov 2001

NYC 9/11 Public Portal Document

■, : ' ' ■ S3 .ENVIRONMENTAL SERVICES;SAMPLE SUBMISSION FORM., A If! 0, <■ WeUJUlLty WESTCHESTER COUNTY LABORATORIEiS AND RESEARCH' ’ /’ 2 Dana Road, Valhalla, New York 10595"' ' ' , •’ ■’ (914)593-5575 - - ’ X 1^

^NYS-ELAPNoMOIG^y ^7“ .ne/Date Set: Form A-70 (rev.-1/96f St Sample Type (circle one): Potable 3. Non-Potable Treafecf, • Bottle #’s:_ PiWq /)'57/ 2. -Non-Potable ■ .4. Other > • J__ . Chain of Custody?yes no s' Time/Date Collected:_ _____________ ■ Comments: Collected By: b ■ Aaencv Code: PWS : Source ID: Type Descriptor: Collected From: Bill to: Location’s/lndividual’s Name. Name/Company, Street_________ ________ Street________ City/St/Zip______________ City/St/Zip

t ■Identification of Source Collection Point 'r' /i /xT.'s Phone#: I CA, CH, Bl? Check#: Fax #: AmouritS

I BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#;___;^_________________ LabxfrV/ Z/gV .(circle tests)/ 7/^ (circle tests) .1. Heterotrophic Plate ■ ' . 1. ,Trihalomethanes.(524) 1. .Purgeable Halocarbons (624/8260)’ e.' Count (hemodialysis & all others) 2..Coliform P/A (public supplies) 2. Volatile Halocarbons (524) 3. Volatile Aromatics (524) 2. Purgeable Aromatics (624/8260) ’ 3.. Acrolein & Acrylonitrile (624) ; 'S’ 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; Organochlorine’Pesticide'sT608/8080) 5, Microscopic ■ 6. Pesticides (507) ■ 6.. PCB's.(Arochlors) (608/8080) ■6. Macroscopic 7. Pesticides/PCB screen (508) 7. Herbicides (SM-.18/6640; 8151), -"’ap: .8. PCB as Decachlorobiphenyl (508A) 8.. Other,Pesticides (SMil8/6636)', ■- W ' }other;_______________ _ 9. Herbicides (515j ' / 9.' Petrote'uni HydrocarbonzScan'(310,-13) 'lb.'Pesticide§:(525y ' ' • lOi'Glycois'in.Water I " , Refrigerated? ves no 11. Carbarnate Pesticides (531) f r ,. '11. Acid'Extractable*s (625/8270)> s 12..Glyphosate. (547), . ■12.- Base,Ne utfal/Extractables(625/8270) . Chionnated?:yes. ’no ‘ ' 13.' Diquat (549) ' ' . ' '' .= 14. Rurgeable Halocarbons (DEF), 14..Chlorination Disinfection Byproducts (551) /Free Chlorine Res:. mg/L . ■l5.;Haloacetic Acids (552)' 15.,PurgeableAromatics(DEE)- ‘16. Other,Pesticides_(SM-18/6630). ' 16. Pesticides (DEF)’ • • Total Chlorine Res; mq/L • 17. Petroleum/Hydrpcarbon Scan'(310-13) 17. PCB’s (Arochlors) (DEF) 1 ■ ■ V. ■ ■ ■

pH

INORGANIC ANALYSES REQUESTED .- Lab#:. (circle tests) 1, Color • . . 20. Acidity ■- . 39. Aluminum 59.' Potassium '2. -Turbidity 21. Alkalinity, as CaCOa ‘ '40. Antimony eo.'Seleniurri. '3. pH ■ 22. Bromide 41. Arsenic ■ 61. Silver’ 4. Conductivity '23. Bromate/Chlorate/Chlorite . 42. Barium;, 62. Sodium ' ■ 5. Corrosivity (temp: “C) ■ 24. Chloride 43. Beryllium ,, '63; -Thalliurn = 6. BOD (5 day) 25. Cyanide ■ 44. Boron - .. 64. Vanadium,’ ■7. .Soluble BOD (5 day) ‘26, Fluoride “ - .45.; Cadmium ' ■' • 7 65. Zinc). 8. Carbonaceous BOD (5.day) 27. Hardness, Total as CaCOs 46..Calcium,;as..CaCO3 ’ -9/ Chemical Oxygen Demand 28. Nitrogen) Ammpnia.as, N? • 47.\Calciuni7Ca*^ ■ • (6'6.’MetaWCN- 1.0. Dissolved Oxygen • 29. Nitrpg'en, Nitrat^as N_. 48.- CKr;qniium,Jbtal- ■67. Volatile . . ■■ MV Total Organic‘Carbon? .■'30’XNitrogen, Nrtrfteaj(,N.\ ■^49,.Chrbmium,\Hexa'yaJentr ^68;Semi-volatiies^ 12 .-.Jot a I Organic. Halides'; 31'. Nitrpge.n,'.T6ta1.kjeld'ahi;as N • ;56'.' CpbalV r69;;^ticicles/^&^' ’;13:,SoHds, Percent'(%),.. 32/;Oil.'ar^ Grease ' ■ ' ^rCppper) ;70;-Disk D'eliverabies: !l

I , Solids,'Settieable^ . 33Y5henol ’ ’ • . 52ilron> ■TCLP- • • . ■ -.7? Solids; Suspended) ■ 34;’Rhpsph'prus.' Total as P' ^/(lead yzTi XGL'R-Metalsj - ri6.\So,lidshTotali , 353 Phdspliorus,\Qrtho as’.P.’ 54.- Magnesium.' . ^72''XCLf-Pesticide^. (i7).’solids';'fotal .Dissplved '36. Sulfates. y' 55'., Manganese.! 73?TCLP.-Herbicides> H 8' Solid's’ Total Volatile; -37/ Surfa'ctarlts' v 56.. Mercufyj ; 74;TCLP-Voiatiles-- ^l9?0tfier: ■' . . 38;.L)V25,4z. 57i Molybdenuml -it.. . J. ..sSyjMfelTef.'.^.^

NYC-WTC_000070847