Chain of custody record, Westchester County Lab, Nov 2001

NYC 9/11 Public Portal Document MW.

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UL ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 LUertchMter County (914) 593-5575 NYS-ELAP No. 10108 Time/Date Set:__________ Form A-70 (rev. 1/96)

Sample Type (circle one): 1j Potable 3. Non-Potable Treated 3 Bottle #'s: _______________________________________ 2. Non-Potable 4. Other V ■^4'.. H f~l Chain of Custody? .yes no Time/Date Collected:.______________________________________ Comments: Collected By:. 41'Agency Code: PWS #:________ Source ID: Type Descriptor:. Collected From: Bill to: Location's/lndividual’s Name. 3 / Name/Company. Street____________________ Street_________ City/SVZip________________ City/St/Zip Identification of Source Phone#: Fax #: . Collection Point.. I CA, CH, Bl?, Check#: Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:;^ ________________ Lab (circle 1^ • (circle tests) 1. Heterotrophic Plata Y Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) r^^;Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) Count (hemodialysis & all others) (^/‘’Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 2. Coliform P/A (public supplies) 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 6y Pesticides (507) 6. PCB's (Arochlors) (608/8080) . .e.^acroscopic < Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) L- PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) {hy^erbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) -

Refrigerated? ves .no ‘ c Pesticides (525) A1? Carbamate Pesticides (531) 10. Glycols in Water 11. Acid Extractables (625/8270) ■ ; 12. Glyphosate (547) 12. Base Neutral Extractables (625/8270) ; Chlorinated?:ves' ■ ng'.' 3. Diquat (549) (^■bc/MS Unknown Scan ; 14. Chlorination Disinfection Byproducts (551) Purgeable Halocarbons (DEF) .Free Chlorine Res: •^il5. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) 'I i'l6. pther Pesticides (SM-18/6630) 16. Pesticides (DEF) r. ~ . Total Chlorine Res: * dy. Petrole'um/Hydrocarbon Scan (310-13) 17. PCB's (Arochlors) (DEF) .. .A " . -‘ji I ‘ ______

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INORGANIC ANALYSES REQI oMab#: (circle tests) ' ' A^linity, as CaCOs lAluminum ■, / I Tl / \ 1. Color ‘ 59. Potassium 2. Turbidity intimony : i I /601 Selenium ‘ 3. pH - ■’ ..senic (^Silver 4. Conductivity , Bromate/Chlorate/Chlorite larium ^'6^.,.Sodium 5. Corrosivity (temp:__ leryllium (^3.:Thallium >-<■ ■

6. BOD (5 day) ; , 44. Boron i^Vanadium ■ . -2g'Fluoride 7. Soluble BOD (5 day) '45. Cadmium OCZinc 8. Carbonaceous BOD (5 day)"- 27. Hardness. Total as CaCOa 46. Calcium, as CaCOs £LE 9. Chemical Oxygen Demand • ' 28. Nitrogen, Ammonia as N 47. Calcium, Ca*^. 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 >, 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 L 52.Jron TCLP 15. Solids. Suspended 34. Phosphorus. Total as P \5yLead 71. TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates /l^Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37. Surfactants I 56. Mercury .r4. TCLP-Volatiles 19. Other: ST-yx _______ 38. IIV254 I 57. Molybdenum 4. "TS. TCLP-BNA's ^g.^Nickel

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