NYC 9/11 Public Portal Document
ENVIRONMENTAL SERVICES SAMPLĘ SUBMISSIÖN FÖRM
N0/20. P 147
WESTCHESTER CÕUNTY LABÖRATORIES AND RESEARCH
•2 Dana Road, Valhalla; New York 10595
aster County
(914) 593-5575
NYS-ELAP No. 10108
ime/Date Set:
Form A-70 (rev. 1/96)
Sample Type (circle one):
Pi07880876612 C0552
1":Potable
3. Non-Potable Treated
Botle, #'s: 0913
0917,98043, K8929
2: Non-Potable
4. Other,
Chain of Custody?
_yes_
_no K8I30, K893!
Time/Date Collected: 00|4
11•20.01
Comments:
Collected By: DiScOTT
Agency Code:
PW$#:
Source ID: :
-Type Descriptor:
Collected From:
Bill to:
Location's/individua's Name_NYC• DEP
Name/Company
Street
19 West LAKE Drve
Street:
City/St/Zip.
VALHALLA NY 10545
City/St/Zip
Identification of Source
Phone#:
Fax #:
Collection Point DELId
CA, CH, BI?
Check#:
Amount$
BACTERIOLOGICAL ANALYSES
ORGANIC POTABLE ANALYSES
ORGANIC NONPOTABLE/SOLID ANALYSES
•Lab#;
(circle tests)
1. Heterotrophic Plate
Count (hemodialysis & all others)
2. Coliform P/A (public supplies)
3. Coliform MPN (priv well, raw, stp)
4. Fecal Coliform (all samples)
5. Microscopic
6.-Macroscopic
:7. AP:
8Other:
Refrigerated?
_yes-
Chiornated?:
yes
Free Chiorine Res:
Total Chlorine Res:
_no
:nõ
_mg/L
mg/l
Lab #:
(circle tests)
Trihalomethanes (524)
Volatile Halocarbons (524)
Volatile Aromatics (524)
Total Trihalomethane Potential (510)
5.
Microextractables (504)
Pesticides (507)
Pesticides/P,CB screen (508)
8.
PCB as Decachlorobiphenyl (508A)
/-Herbicides (515)
Pésticides" (525)
Carbämate 'Pesticides (531) 1:
12. Glyphosate (547)
13. Diquat (549)
14: Chloriñation Disinfection Byproducts (551)
-15. Haloacetic Acids (552)
16. Othër Pesticides (SM-18/6630)
1.7..Petroleum/Hydrocarbon Scan (310-13)
1.
2.
Purgeable Halocarbons (624/8260).
Purgeable Aromatics (624/8260)
Acrolein & Acrylonitrile (624)
4.
Phthalates (606/8060)
5
Organochlorine Pesticides (608/8080)
6
7
PCB's (Arochlors) (608/8080)
Herbicides (SM-18/6640; 8151)
8.
Other Pesticides (SM-18/6630)
9.
Petroleum Hydrocarbon Scan (310-13)
:10.: Giycols in Water
11. Acid Extractables (625/8270)
12, Base Neutral Extractables (625/8270)
13./GC/MS Unknown Scan
14. Purgeable Halocarbons (DEF)
15. Purgeable Aromațics (DEF)
16. Pesticides (DEF)
17. PCB's (Arochlors) (DEF)
INORGANIC ANALYSES REQUESTED
*Lab#:
(circle tests)
Color
.Turbidity
3.
pH•
.4.
Conductivity
5:• Corrosivity (temp:.
C)
•BOD.(5 dạy) .
7::Soluble BOD (5 day)
r Chemical Oxygen Demanid.
•10. Dissolved Oxygen
11: Totạl Organic Carbon
12. Totãl, Organic Halides
i3:Sólids; Percent (%)
;14 Solids. Settleable.
„5.,Solias, Suspended,
$16. Solids, Total;
"17: Solids: Total Dissolved
18, Solids: Tojal Volatile
Other:
Acidity
• Alkalinity, as CaCO3
:Bromide
.Bromate/Chlorate/Chlorite
Chloride
Cyanide
26. Fluoride
27. Hardness, Total as CaCOa
28. Nitrogen, Ammonia asN
29 Nitrogen, Nitrate as N
302 Nitrogen; Nitrite as N
31: Nitrogen, Total Kjeldahl as N?
32 Oil'and Grease
33 Pheno!]
341 Phosphorus Total as P
35*PhosphorusOrthoras P
36. Sülfates!
3Z/ Surtactants
38LLIV254;
7846
39. Aluminum
(40>Antimony
41. Arsenic
42. Barium
43. Beryllium
44. Boron
45. Cadmium
46. Calcium, as CaCO3
'47. Calcium, Ca*'
48.Chromium, Total
49: Chromium, Hexavalent.
50 Cobalt 4
51. Coppeї
52-rön'
malds
54 Magnesium:
B.Manganese,
56: Mercury,
574Molýbdenum:
58: Nickell
59. Potassium
60. Selenium
61. Silver
62. Sodium
(63)Thallium
64. Vanadium
65. Zinc
CLP
66. Metäls/CN
67. Volatiles'"
68. Semi-volatiles
69. Pesticides/PCB's
70. Disk Deliverables
TCLP
7.1 TCLP Metals"
172: TCLP-Pesticides
73 TCLP-Herbicides
74: TCLP-Volatilês!
75JTCLP-BNA'Ş)
NYC-WTC_000070964
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