Chain of custody record, Westchester County Lab, Nov 2001

NYC 9/11 Public Portal Document

environmental services sample submission FORM ’ \ WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla,'New York 10595 t (914)593-5575 NYS-ELAP No. 10108 k Time/Date Set:' Form A-70 (rev. ,1/96j;- JSarpple Type (circle one): 1,.-Potable . 3. Non-Potable Treated Bottle #’s:. 2. Non-Potable 4. Other Chain of Custody? .yes___ _no Time/Date Collected:. r-iXag? Comments: Collected By: Aoencv Code: PWS #:______ _ Source ID: Type Descriptor:. Collected From: Bill to: Location’s/lndividual’s Name. Name/Company t''. Street_UllM5L^:^^lJ5^S£il______ - Street_________ _ City/st/Zio'^ A/V City/SVZip Identification of Source. Phone#:________ Fax #:_ • Collection Point, rzfor;/-/ I CA, CH, Bl?_ Check#:, r Amounts.

BACTERIOLOGICAL ANALYSES ORGANIC.POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES ■ Lab#:_________________________ Lab _____________________ (circle tests) (circle tests) ’ ■- 1. Heterotrophic Plate 1. Trihalom.ethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) ' ' 2. Coliform P/A (public supplies) Volatile Anomalies (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw,.stp) 4. Total .Trihalomethane Potential (510). 4. Phthalates (606/8060) 4’. Fecal Coliforrh (all samples)'.- ' , 5. . Microextractables (504) 5. 'Organochlorine Pesticides (608/8080) 5. Microscopic' 6. Pesticides,(507) 6. PCB^ (ArochlorsX(608/8080) ,J.,6. Macroscopic' 7. Pesticides/PCB screen (508) 7.;. .Herbicides (SM-Jj 8/6640; 8151) ■5

I < ’• . ■ 8.pther:L___^^_i_^_^ ............................... Y 8. PCB'as.Decachlorobiphenyl (5.08A), ■ 9; Herbicides'(515)' iq::Pesticides-(525)' ' ' ' 8., .Other P^ticife^SMTl 8/6630) 9.': Petroleum Hydr^arbpn.Scan (310-1.3) 10.'Glycolsin’Water^;. -T

* Refrigerated?^' yes’'-LiOb'; 1 f. CarCamate Pesticicles (531)' ij.'.XciS Ext'ractables'(625/8270)' 12. Glyphosate (547) > ■ J4^ase Neutral Extractables (625/8270) - Chiorinated?:7 yes'-*-, -no'- 13. Dki'uat (549) j .h J^GC/MS Unknown .Scarl •' 14. Chlorifiatign Disinfection Byprodftcts'(551) ’ 14. Purgeable Halocarbons (DEF). j®' Free Chlorine ResF ;^mg/L ■15..Hal^ceticV\cids (552).-- fc' " ‘ 15..Purgeable Ar'omatics (DEF) <■ 16. 6the?Pesticides(SM-18/6630) h . 16.*Pesticides (DEF) i ' Total Chlorine Res: /::mg/L • ■17. Petrole.um/Hydrocarbon Scan (3W-13) 17. PCB’s (Arochlors)\DEF)

I* £H - i * i ■ Ty: ■ INORGANIC ANALYSES REQUE^STED - Lab#: I ■' (circle tests) ■1. 1. Color 20. Acidity ’ ■ 39..,Aliiminum 2. Turbidity 21. Alkalinity, as CaCOs {40..,/AntOTony 60.-Selenium ,. ' -T \ ■ 22. Bromide '41'*. Arsenic . Silver - J A ■ \ 3. pH 4.- .Conductivity 23. Bromate/Chlorate/Chlorite. 42.>Baam ^PASodiprp. ; • L 5. Corrosivity (temp: 6. BOD (5 day) .°C) 24. Chloride 25. Cyanide \43^Be^llium' 44. Bofon .. ' ' 63.jThallium \64.^Vanadi'Um .

H- -7. Soluble BOD (5 day) • 26. Fluoride^ 45. Cadmium eSYZinc •

S;-- . 8, Carbonaceous BOD (5 day). - 27.,Hardness, Total as CaCOs 9. ■ Chemical Oxygen'Dennand 28. Nitrogen, Ammonia as'N , 46. Calcium, as CaCOa . .1 CLP' • \ ■ -66. Metal^CNl • 10..Dissolved Oxygen 29. Nitrogen, Nitrate a? N - ' 48. Chromium,. .Total., , 67. Volatiles'; 1,1. Total Organic Carbon ' " 3p'? Njti;dgen,Nj1n1e,as N ' . 49.' Chromiu,m', Hexav'alenp 68. Semi-volatiles^ ) Total .Organic, Halides ’’ 12^ Totaljbrgahic.Hal'ides 12. 3V.,Njt.mgen>T}3t.alKjeldahl as <5.0.-Cobeli' ' 69? Pesticidei/PCB's- )■ /' \l‘3;‘Sdlids;. Percent, (“/o’); ■' 32.'O]i''a'nd(Grease .';Cdp|Ser. i.70>biskbe!wera^ kV >14>SdiidsXSettleabje' 33.«Ph'enolJ ' j ^'.^/jron^ fICLP; - i Si-Gilds'; Sjjspend.edJ- P^KoruskTcrt^lV C • ZlTjCLg-Metals, ^16. Splids^.^al/, 65: PlTOSpl^US}.,Q'rtra ^P.' ' ■ ..^VJ 'Zi^T^Lp-^ticides;. S^^.^uifates- ^^^ai^seP 73.'.TCLR,H'efbicidds 37/S*urfactants; ‘ . • ^^M^ci^.- ^^tfC^VoIatiles> 75tt.crB-^A:s> ♦ _

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