Chain of custody record, Westchester County Lab, Nov 2001

NYC 9/11 Public Portal Document ■........................ ■■■■' .......................

UI ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road. Valhalla, New York 10595 UlMtchMter County (914) 593-5575 NYS-ELAP No. 10108 Time/Date Set:_________________________ Form A-70 (rev. 1/96) Sample Type (circle one); 1. Potable 3. Non-Potable Treated Bottle #’s:. i"’ I Hu Cy 2. Non-Potable 4. Other________ __ Chain of Custody? yes no Time/Date Collected:_______ 1 I I I C ) Comments: Collected Bv: {. - A i > Agency Code: PWS #:_________ Source ID: Type Descriptor: Collected From: Bill to: Location’s/lndividual’s Name. V i f id Name/Company Street__________________ Street__________ City/St/Zip______________ City/St/Zip Identification of Source Phone#: Fax #: Collection Point r k? - N 17 9 / 6 I I CA, CH. Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:______________________ Lab #:_______ (drcle lesis) L (circle lests) 1. Heterotrophic Plate 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2. Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) 3. 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) * ‘ 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: ‘Id ■‘9. Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) I. ! 10. Pesticides (525) ' io;Glycols in Water Refrigerated? .yes no • hl. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) \12. Glyphosate (547) Baise Neutral Extractables (625/8270) Chlorinated?: yes no ;,13. Diquat (549) ' Q3^C/MS .Unknown Scan t\14. Chlorination Disinfection Byproducts (551) Purgeable Halocarbons (DEF) Free Chlorine Res:. i15.’Haloacetic Acids (552) . , IS. Purgeable Aromatics (DEF) ■ .16. Other Pesticides (SM-18/6630) ' 16. Pesticides (DEF) Total Chlorine Res: ■ —-------------------------- ■ fi> ‘17. Petroleum/Hydrocarbo'n Scan (310-13) „ 17.'PCB’s (Arochlors) (DEF) ri?' -L ‘‘ P-H^ - -------- INORGANIC ANALYSES REQU^^DJ^^b#~ZZZZZZZZ 1. Color j^Ac^ity 39. Aluminum 59. Potassium 2. Turbidity ;i^^AlKalinity, as CaCOa 40. Antimony 60. Selenium 3. B^rnide 41. Arsenic 61. Silver 4. Conductivity Broirhate/Chlorate/Chlorito 42. Barium 62. Sodium 5. Corrosivity (temp:______ °C) 5^:<^6ride 43. Beryllium 63. Thallium 6. BOD (5 day) J^’.C^nide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) '2'6: Fluoride 45. Cadmium 65. Zinc 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOs 46. Calcium, as CaCOa ' CLP 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. CalciunvCat? 66. Metals/CN " 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N 48. 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 50. Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron TCLP 15. Solids. Suspended 34. Phosphorus, Total as P 53. Lead 71. TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55. Manganesei 73. TCLP-Herbicides 18. Solids. Total Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles 19, Other:_____________ 38. I. IV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel A

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