Form documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.
NYC-WTC_000071045–000071053Folder label: “28427”
OCR status: ok · source: pdftotext
NYC 9/11 Public Portal Document
ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM
UI Utertchoster toontv
Time/Date Set:__________ WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 1
NYS-ELAP No. 10108 Form A-70 (rev. 1/96)
Sample Type (circle one): y Potable 3. Non-Potable Treated Bottle #’s;. 2. Non-Potable 4. Other. Chain of Custody? yes no Time/Date Collected:. Comments: Collected Bv: ■■ ■< Agency Code: PWS #: Source ID: Type Descriptor:
Collected From: Bill to: Location's/lndividual’s Name. Name/Company. Street____________________ Street_________ City/St/Zip_________________ City/St/Zip Identification of Source Phone#: Fax #: 4 I CA, CH. Bl?.. Check#: Amounts Collection Point.
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) Y , Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) A Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 2. Coliform P/A (public supplies) 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) 7. API 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 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) 12> Base Neutral Extractables (625/8270) Chlorinated?: .yes. no 13. Diquat (549) G.'GC/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine Res: mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (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)
pH.
INORGANIC ANALYSES REQUESTED -Lab#: (circle tests) 1. Color 20. Acidity /39\Aluminum 59. Potassium 2. Turbidity 21. Alkalinity, as CaCOg I 40.|Antimony /€9\Selenium 3. pH 22. Bromide 41 .lArsenic (ejy Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite I 42.JBarium 62. Sodium 5. Corrosivity (temp: .°C) 24. Chloride Beryllium Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium Zinc____________ 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOa 46. Calcium, as CaCOa CLP 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 4Y Calcium, Ca*^ 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N Q^Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromium, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen. Total Kjeldahl as N ^OSCobaH 69. Pesticides/PCB’s 13. Solids. Percent (%) 32. Oil and Grease 51 .popper 70. Disk Deliverables 14. Solids. Settleable 33. Phenol 52. (Iron TCLP 15. Solids. Susperided 34. Phosphorus. Total as P ^Lead 71. TCLP-Metals 16? Solids. Total 35. Phosphorus, Ortho as P Magnesium 72. TCLP-Pesticides 17. Solids. Total Dissolved 36. Sulfates /S^Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37 Surfactants I 56. Mercury 74. TCLP-Volatiles Other: Sk_______ 38. I. IV254 j 57. Molybdenum 75. TCLP-BNA’s k 58./ Nickel
NYC-WTC_d00b71047
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NYC-WTC_000071265
Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.997
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071429
Document tracking the custody and handling of environmental samples submitted to Westchester County Department of Labs.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000070569
Chain of custody documentation for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071184
Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research including contact information.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071089
Form documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071817
Document tracking the transfer and custody of samples received by Westchester County Department of Labs & Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072362
Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072080
Document recording the transfer and receipt of environmental samples at the Westchester County laboratory.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.996
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000070652
Record documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071567
Form tracking samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071655
Form tracking samples submitted to the Westchester County Department of Labs and Research.
11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.995
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027356
Document tracking the custody and handling of environmental samples submitted to the laboratory.
11 shared non-person entities · 1 shared topics · similarity 0.995
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