Chain of custody record, Westchester County Lab, Nov 2001

NYC 9/11 Public Portal Document

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UI Ulectehester County ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH *■ 2 Dana Road, Valhalla. New York 10595 (914) 593-5575. X / ‘ • *

^NYS;ELAP No. 10108 K Time/Date Set:__________ Form A-70 (rev. 1/9^"

Sample Type (circle one): Potable 3. Non-Potable Treated ■ . • ? ' • •

2. Non-Potable 4. Other Chain of Custody? L yes no ' Tirhe/Date Collected: I Comments: Collected By: L ■ lAY CtcFr .Agency Code: PWS #:__________ Source ID: Type Descriptor: Collected From: Bill to: Location's/lndividual’s Name Name/Company Street iM Vr O- . f Street___________ City/St/Zip H ■:-> j i r A? > ■ i e \ YN City/St/Zip Identification of Source Phone#: Fax #: Collection Point, ■'') 1 L r ( ? I CA. CH, Bl? Check#: Amounts

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:_________________________ Lab #: ______________________ :__ . (circle tests) (circle tests) 1. Heterotrophic Plate ' 1. Trihalomethanes (524) . . .1. Purgeable Halocarbons (624/8260) , Count (hemodialysis & all others) '2?J Volatile Halocarbons (524) ' vZ Purgeable Arornatics (624/8260) 2. Coliform P/A (public supplies) Volatile Aromatics (524) 3?'''Aci'olein & Acrylonitrile (624) a '3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (510) • 4. Phthalates (606/8060) Y :4.' Fecal Coliform (all samples) 5. Micro'extractables (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>I8/^640; 8151) 7. AP; 8. PCB as Decachlorobiphenyl (508A). 8. Other Pesticides (SM-18/6630), • ‘ /■

8. Other:, 9.., Herbicides (515) ; 9. Petroleum Hydrocarbon Scan (310-13) ’ 10. Pesticides (525) .’ . , . 10. Glycols in Water ■ Refrigerated?yes ' no, 41. Carbamate Pesticides (531) • 11. Acid Extractables (625/8270) 12. Glyphosate (547) 12., Base Neutral E>rtractables (625/8270) Chlorinated?:yes no 13. Diquat (549)' - fl'^GC/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) YSTPurgeableS-lalocarbons (DEF) Free Chlorine Res:. mg/L' 15. Haloacetic Acids (552) 15. Purgeable Arbrpatics (DEF) 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)

:/ 7717 INORGANIC ANALYSES REQU^EC^tab#:, (circle tests) ’'ig f 1. Color - -,/'’26.Acidity 39. Aluminum 59. Potassium 2. ’Yurbidity •<?1.?^lkalinity, as CaCOa 'Antimony 60. Selenium 3. pH. ' . 7(22. Bromide 41. Areenic 61. Silver ■4. Conductivity , .-_-''23. B/omate/Chlorale/Ch!orite , 42. Barium 62. Sodium 5/ Corrosivity (temp: ,°C) .,<^4. ^blonde /43.' Beryllium (^IThallium 6.. BOD (5 day) Cyanide 44. Boron J 64. Vanadium 7. ; Soluble BOD (5 day) '^6.'Fluoride 45. Cadmium / 65. Zinc________________ 8. Carbonaceous BOD (5 day), 27. Hardness, Total as CaCOa '46. 'Calcium, as CaCQ^ CLP . ; 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calciurn. Ca^ 66.-Metals/CN , 10. Dissolved Oxygen - 29. Nitrogen,-Nitrate as N 48. Ch’romiurh, Total, '67. Volatiles -11. Total Organic Carbon 30. Nitrogen, Nitrite as.N ' 49. Chromium;*Hexavalerit 68. Serni-volatiles. 12. Total Organic Halides 31 .'.Nitrogen, Totarkieidahl as N. (50J Cobalt 69\Pesticides/PCB’s 13.'Solids, Pe'rcent (%) 3Z*Oil’an'cl'Gre'ase 5Y Copper '70?Disk Deliverables 14. Solids, Settleable ■ - ’ 33?Phenol'- " TCLP IS.' Solids. Suspended; M.-phosphorus. Total.asl?, SS.^Lead^^ ^^lLT;CL5;Metal$^ l e.'Soiids, Total I- . 35. phpsp’hprus.'prtho as.^ , 54; Magnesium,* , 72.'T(^-^Pesticides j .17. Solids, Total Dissolved^ ' - ' 3^'Sju|fates>. - .. V.- /55/lManganese> ■ 73-..fCLP-Herbicides. 1,8..Solids.-Total Volatile. .’ 3^/,sb'i\acfants.; • ''' < ,''&6^.Mercury:; ■'74'/rGO3-’^lSilesr Tl^Other^^ /^/'MblyiJdenurtl) ' ' ^7,5?TCLP-BNA’sj ^7,. ,, Ia y ----- r : ^.5e:;Nicfei; ___________________ _____________ 1!

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