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Chain of custody record, Westchester County Lab, Nov 2001

Machine-extracted title · confidence 90%

Chain of custody form for samples submitted to the Westchester County Department of Labs and Research in Valhalla, NY.

NYC-WTC_000070918–000070927

Folder label: “28855

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Scanned page image, NYC-WTC_000070920
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NYC 9/11 Public Portal Document ENVIRONMENTAL SÉRVICES SAMPLE SUBMISSION FORMi. WESTCHESTER COUNTY LABORATORIES AND RESEARCH! 2 DầnaRoad,•Välhälläy Nëw:York 10595 ester County (914)$935575 Time/Date Set: Sample Type (circle one): Potable 3. Non-Potable Treated Non-Potable: 4. Other Time/Date Collected:- 11.35-01 0922 Collected Bý: NEWANN Agency Code:L Collected From: Location's/Individual's Name. ATE DECDENIrO Street City/SV/Zip. WAHAHA, VY: lUStE Identification of Source. Collection Point_ "7!17 ¿ Böftle'#'s: Chain of Custody? Comments: PW$ #: Bill to: Name/Company. Street City/SV/Zip. Phone#: CA, CH. BI? BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES Lab#: (circle tesis) 1. Heterotröphic Plate Count (hemodialysis & all others) 2. Coliform PIA (public supplies) 3. Coliform MPN (priv, well, raw, stp) 4. Fecal Coliform (all samples) 5. Microscopic 6. Macroscopic / y.APi •8. Other:: Refrigerated? yes. no Chiornated?: Free Chlorine Rés: yes mg/L Total Chlorine Res: _ :mg/L Lab#: (circle lests) Trihalomethanes (524) Volatilé Halocarbons (524) Volatile Aromatics (524) 4: •Total Trihalomethane Potential (510) 15: Microextractables (504) Pésticides (507) 7: Pesticides/PCB screen (508) 8. 9. PCB as Decachlorobiphếny| (508A) Herbicides (515). '10: Pesticides (525): 11: Carbamate Pesticides (531). •12: Glyphosate (547): 13: Diquat (549)J .14: Chlorination Disinfection Byproducts (551) 15. Haloacetic Acids (552) 16. Other Pesticides (SM-18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) pH INORGANIC ANALYSES REQUESTED - Lab#: (circle tests) 1. Color 2. Turbidity 3. pH .4. Conductivity 5. Corrosivity (temp:_ °C) 6. BOD (5 day) 7. 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 (%)! )4: Solids, Séttléablé f15. Solids. Suspended* 11.6. Solids‹Tötäl '1,7. Solids: Totãl Dissolved" !18 :Sòlids; Ț.õłal,Völătile $19. Other: 37 Sürfactants: 3841IV254 20. Acidity 21. Alkalinity, as CaÇO3 22. Bromide 23. Bromate/Chlorate/Chlorite 24. Chloride 25. Cyanide 26. Fluoride 27. Hardness; Total as CaCOs. 28. Nitrogen, Ammonia as N.. 29.:Nitrogen; Nitrate as N: 30.Nitrogen, Nitrite asN. 31. Nitrogen; Total Kjeldahl as'N .32nQiland Grease 334Phènol 34: PhosphorusATotal as P 35: Phosphorus, Orho as P 39₽ Aluminum '40. Antimony 41: Àrsenic 42. Barium 43. Beryllium 44. Boron 45: Cadmium 46. Calcium, as CaCO3. 47 Calcium Gatmi 48: Chromium, Total. 49. Chromium, Hexavälent '50:'Cobalt 51: Copper 52, Iron: 53! Leady 54-Magneșiumi 55. Mänganese 56! Mercury/ "57: Molybdenum 58! Nickel! NYC-WTC_000070920 NYS-ELAP No.10108 Form A-70 (rev. 1/96) iyes.no Source ID:: {Type" Descriptor: Fax#: Check#: Amount$ ORGANIC NONPOTABLE/SOLID ANALYSES 1. Purgeable Halocarbons (624/8260) 2. Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) 4. Phthalates (606/8060) Organochlorine Pesticides (608/8080) 6. PCB's. (Arochlors) (608/8080) 7., Herbicides (SM-18/6640; 8151) Other Pesticides (SM-18/6630) 9.?. Petrölëum Hydrocarbon Scan (310-13)5 10. Glycols in Water. 11 . Acid Extractables:(625/8270) 12; Base Neutral Extractables (625/8270) GC/MS Unknown.Scan. 4. Purgeable Halocarbons (DEF) 15. Purgeable Aromátics (DEF). 16. Pesticides (DEF) 17. PCB's (Arochlors) (DEF) Xuit) tüca? 59.Potassiom, Aw 60. Selenium 61. Silver 62 Södium *63 Thallium istai 64-Vanadium 65.-Zinc CLP?E 66. Metals/CNJ 67 Volatiles: 68. Semi-volatiles ,69. Pesticides/P,CB's 701Disk Deliverables TCLP 71: TCLP Mètals, 72:TCLP-Pesticides:, 73!TCLP Herbicides; $74.ȚCLP-Volätilés 75:ICLP-BNAS)

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NYC-WTC_000070920Source: NYC Law Department, mirrored locally

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