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Chain of custody record, Westchester County Lab, Nov 2001

Machine-extracted title · confidence 95%

Form documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000071022–000071025

Folder label: “28325

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Scanned page image, NYC-WTC_000071024
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NYC 9/11 Public Portal Document Wesich oster County F Time/Date Sët: Sample type (circle one). Potable 3.-Non-Potable Trèated :2. Non-Potab 4. Other Timè/Date Collected: 0858, 1/:19.07 Collected By: 7. 5C5TT. Agency Code: Collected From: Location's/individual's Naine NYC DEP street | 19 WeSt LAKE DRIVE City/St/Zip_: • VALHALLA NY 10595 Identification öf Source Collection Point_ /EL 18 ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH '2 Dana ã Roäd, Valhallä; New York 10595 : "(914) 593-5575: 'NYS-ELAP No.10108 :Form A-70 (rev. 1/96)= C0565 @878, QFGET8 QE8T Bottle #'s: _ P7IO,PIV2 PRB1060 K9074 Chain of Custody? no:Klk22(K4354, Comments: KVOCTRIP BLANK • чд. PW$ #:. _Source ID:__Type Dèscriptor Bill to: Name/Company Street City/SVZip Phone# Fax #: CA, CH, BI?- Check#: • Amount$ BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES ￾Läb# (circle iests) 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3: Coliform MPN (priv well, raw, stp) 4.Fécal Coliform' (all samples) 5. Microscopic 6. Macroscopic TARL : 8. Other: Rétrigerated?"_ _yes_ Chiornated? _yes Free Chiorine Res: in :Toral Chiorine Res: no mğ/l mg/L: ph. Lab #: (circle tests) Trihalomethanes (524) 12. 4. Völatile Halocärbons (524) Volatile Aromatics (524) Total Trihälomethane Potențial (5.10) Microextractables (504) Pesticides (507) :Pesticides/PCB, screen (508) 8 P.CB as Decāchlorobipheny! (508A): 'Herbicides (515). 'Pesticides (525): : Carbamate Pesticides (531) 12. Glyphosäte. (547) 13: Diquật (549)" 4. Chlorinätion'Disinfection, Byproducts, (551) i15 Haloacetic Acids (552) Other Pesticides (SM-18/6630) [17. Petroleüm/Hydrocarbon Scan (310-13) ..1." Purgeable Halocärbons (624/8260) : 2. Purgeable Aroiatics (624/8260) 3. Acrolein & Acrylonitrile (624) •4. Phthalates (606/8060)•: 5.Organochiörine Pesticides: (608/8080): PCB'ş (Arochorş)(60®/(080) 7.: Herbicides (SM-18/6640; 8151) 8. Other Pesticides (SM-18/6630) 9. Petroløum Hydrocârbon 'Scan (310-13 i0. Glycols in Water 11. Acid Extractables (625/8270) 12. Base NøutralExtractables (625/8270) (3GC/MS Unknown Scan 14. Purgeablé Halocarbons (DEF).- 15. Purgeable Aromatics (DEF) 16. Pesticides (DEF) 17: PCB's (Arochlors) (DËF) INORGANIC ANALYSES REQUESTED Lab#: .(circie tests) Colör 2.»Turbidity. 3. рн 4. Conductivity 5. Corrosivity (temp: 6. BOD (5 day) °C) 7 Soluble BOD (5 day) 8 Carbonaceous BOD (5'day)... Chemical Oxygen Demand, 10:Díssõlved Öxÿgën '11. Total Organic. Carbon 12"Total Organic Halides ‹13 Solids,Perçènt:(%)!" 14 Sölids, Sětleable" |15)Solids:Suspended, (!64sclids, Total)}" 17. Solids: Total Dissolved) 18 Solidsi Totàl Volatile: 190h0r =56 Acidity Alkalinity, as. ÇaCO3 Bromide 28 Bromate/Chlorate/Chlorite Chloride 25 Cyanide 26. Fluoride: 27. Hardness, Total as CaCO3, 28. Nitrogen, Ammonla asN. 29. Nirogen; Nitrate as'N. 30: Nitrogen; Nitrite as N; Nitrogen;Total, Kieldählas N: 32: Oil and Grease; 33 Phenoi› 34 Phosphorus: Total:as P: .35.tPhosphorus: Ortho as:P 36:Sultätes 37. Surfactants) 38ALV254j 8326 39. Aluminum ,Antimony, 41: Arsenic Barium Beryllium Boron 45. Cadmium 46. Caicium, as Caco, 47Calcium, Ca! 48. _Chromium, Total: 49 Chromium: Hexavalent; (50. Qobäht) 51: Copper™ 52:Non) 53 Leadke Mägnesium; vanganese 6AMercury Molybdenum 583N fickels 59. Potassium .60. Șelenium 61. Silver 62. Sodium. "lyc (63.Thallium 64: Vanadium 65: Zinc.. ICLPL i66. Metälš/CN : 67:Volatiles :68. Semi volatiles 69."Pestičides/PCB's 7O Disk Deliverables FTCLPT TZIC Metals 72. TCLP-Pésticides 73 TCLP Herbicides: TÄLTCLP Volátiles) 75 TCLPBNAS) +92% mitit NYC-WTC 000071024

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NYC-WTC_000071024Source: NYC Law Department, mirrored locally

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NYC-WTC_000072226 · Box DEP Box 61

Document tracking the chain of custody for samples submitted to the Westchester County Department of Labs & Research.

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