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.' ■ ■' ' (914)593-5575 NYS-ELAP No. 10108 < I ime/Date Set;_________ Form A-70 (rev. 1/96) Sarppjft Type (circle one): 1. PotabJ^ 3. Non-Potable Treated Bottle #’s;. 2. Non-Potable 4. Other_______ Chain of Custody? .yes no Time/Date Collected; Comments; Collected Bv; < O // Agency Code; PWS #;________ Source ID; Type Descriptor; Collected From; . , _ Bill to; Location's/lndividual’s Name ■ /// G i Name/Company Street__________ City/St/Zip/OCjyS) 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 tests) (drc.le tests) 1. Heterotrophic Plate 1. Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) * Count (hemodialysis & all others) Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 'J 2. Coliform P/A (public supplies) J}/ 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) JJ ,AP; 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) o. Other;___________________ 9. Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13)' ' .f 10. Pesticides (525) 10. Glycols in Water Refrigerated? .yes. .no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) ■j 12. Glyphosate (547) IZ Base Neutral Extractables (625/8270) Chlorinated?; yes no 13. Diquat (549) GC/MS Unknov/n Scan 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine Res; mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) i

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)

£H, I A

INORGANIC ANALYSES REQUESTED - Lab#; (circle tests) iWo I 1. Color 20. Acidify 39. Aluminum 59. Potassium 1 2. Turbidity 21. Alkalinity, as CaCOa <^4.6? Antimony 60. Selenium « i 3. pH 22. Bromide 41. Arsenic 61. Silver ■ / 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium ' I 5. Corrosivity (temp; .°C) 24. Chloride /^3?Beryllium <^. Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOa 46. Calcium, as CaCOa CLP J 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

-a 3 11. Total Organic Carbon 30. Nitrogen, Nitrite as N Chromium, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N Cobalt 69. Pesticides/PCB's ’ 3. Solids, Percent (%) 32. Oil and Grease 51.Copper 70. Disk Deliverables \ *. Solids. Settleable 33. Phenol (^. Iron ICLP J is. 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 Manganese 73. fCLP-Herbicides I 1^ Solids. T^al Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles j Other; 38. IJV254 Molybdenum 75.TCLP-BNA's J Nickel

NYC-WTC_000070946