NYC 9/11 Public Portal Document
H ilWjf ENVIRONMENTAL'SERVICES SAMPLE SUBMIT A Q' •
■■■ , WESTCHESTER COUNTY LABORATORIES AND'rESEARCH Z
■/■. .UJI’ 2Dana’Road, Valhalla, New .York 10595- ' .F
'■ t ’ • '/ ' • (91,4)5^3-5575. NYS-ELAP No. 10T'^
ime/Date Set? -■ - •- ... ■ ' Form A-70 (rev. 1/96;/■
Sample Type (circle one):
(^Potable 3. Non-Potabie Treated - ' Bottle #’s^ 3f P if '
' 2. Non-Potable 4. Other . Chain of Custody? '' ves no".
Time/Da'te Collected: ti- a t Comments:;;
Collected Bv:^ .Agency Code: PWS #:_______ Source ID: Type Descriptor:.
Collected From: Bill to:
Location’s/lndividual's Name^iHG Name/Company.
Street H P GJ V £ Street________
City/SVZiplLlLZil!£llGj_J^sM__J^//^^ City/St/Zip
Identification of Source_________ __ ____________ Phone#: ___ Fax#:.
Collection Point, ' tflG> GG-HI I CA. CH. Bl? Check#: Amounts.
BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES
Lab#:________________ Lab #:___________________
(circle tests) (circle tests)
1. Heterotrophic Plate • Gv Trihalomethanes (524) 1. .Purgeable Halocarbons (624/8260).
Count (hemodialysis & all others) Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260)
2. Coliform P/A (public supplies) ..37 Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624)
3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (510) ?■ 4. Phthalates (606/8060)'
4. Fecal Coliform (all'samples) ' ' ■ 5. Microextractables (504)' : v ’ 5.'- Organochlorine Pesticides (608/8080)
5. Microscopic 6. Pesticides (507) 6. PCBJs (Arochlors) (608/8080)
6. Macroscopic 7. .Pesticides/PCB screen (508) 7.; Herbicides;(SM;18/6640; 81.51) =
17. API •8. PCB as Decachlorobiphenyl (508A)
‘9.. Herbicides (515)
8.? (^her^PesticidesJSM^I 8/6630)
; .9? • -Petroleum riydfocarBon Sca'n'(310-13) G
Refrigerated?
—
yes no
1 110. 'Pesticides (525)
il 1. Carbamate Pesticides (531) •
10. Glycols Tn Water
11'. Acid Extractabtes-(625/8270) -
^12. Glyphosate (547) 12_^ase NeutrarE)rtracta.ble"s■(625/8270);
1 (Ts. GC/MS'Unknown Scan
Chlorinated?: ’ .yes ho t13. Diquat (549)
') r4tPurgeable Halocarbons (DE/)'.,
;14. Chlorination Disirifection Byproducts (551) .
Free ChJorine Res:. .mg/L .15. t-)aloacetic 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).
■ph; M- • /
INORGANIC ANALYSES REQUESt|piiLab#:
(circle tests)
1. Color ■ ■
39. Aluminum Potassium
2. ..-Turbidity WAtaify. as CaCOa . >■; . Antimony , 60. Selenium
3.' pH . '^.Br^ide ' ; , 41. Arsenic 61. Silver
4. Conductivity . j» j?23?Bromate/Chlorate/Chlorite . Banum- 62. Sodium
5. Corrosivity (temp: IC) '♦’SlB'cloride ' . (4^Beryllium ^^^Thajlium”
6. ; BOD (5 44. B oro ri . pj Vanadium
- day)
..
.1.7. Soluble BOD (5 day) ,26. Fluoride ■■ 45. Cadmium' 65. Zinc , ■ '
.8. Carbonaceous BODJS day): 27.-Hardness, Total^as CaCOs’ 46. Calcium, as CaCOa. CLP "
, ' 9. Chemical Oxygeri b'eman'd . ,2J.'Nitfdgeri; Ammonia as N ” ■ 47;‘Calcium', i66.^Metals/CN
10/.pis'splyed Oxygen'- 29? Nitrogen, Nitrate as N 48. Chromiuni,-,Total.< i67.^ Volatiles;. ,
IT. jotalOrganic?^Carbon: ^ij^tro'geii. Nitrite as N, 49'Ch’rorriiurti, Hexavalent; (eSrSerni-volatiles'
/. 'l^/TbtalCJfganicLHalides ’SJ^Rrtrogen;/Total Kjeldahl as N |6^.^>ticide^RCffs?.
V ISiSolids? Percent (%’)*’ 32.’oil 'and Grease l^^Co^er '7O.'Disl<C)eliv’erables
aSVpiiendl TCL&. ’ '
G .^GSolidsl§us'gendedi ‘ ' ;,^.^phbspfip.rusJ,Tpta!;as;P^ 53.-Lead^ l^llTCLg^etaJs.,
:i6<Sc^s/;^taP.. ‘s^.^hosphorusrO.rthoas. j^vJ^gnesium" XCL^-PesUddesj
I'W'^QWsi/Total.Diss.olwd. 36>Sujfates> Manganese: ?73?JCU^AerBSci(le^-
flfeSolidsi.TojalXolatil^ ’ ^/■.Surfactahtsj , ^^Me.rcufy, - [?ALT&P-Volahles;
! '75^.TCrR?BNAls,.
OGzbzLL. ^Liy25Jj ^MpJyBberiu'mi
.. .^Nidk'di.:
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