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
111 ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH li 2 Dana Road, Valhalla, New York 10595 Utertchostef County NYS-ELAP No. 10108 (914)593-5575 Time/Date Set:____________________________ Form A-70 (rev. 1/96)
Sample Type (circle one): Y 7 Potable 3. Non-Potable Treated Bottle #’s:_Ji2_
2. Non-Potable 4. Other Chain of Custody? yes no 5 Time/Date Collected: Comments: Collected Bv: C- Agency Code: PWS #:__________ Source ID: Type Descriptor:
Collected From: Bill to: -J — '•)
Location’s/lndividual’s Name. Name/Company Street_____________________ Street___________ City/St/Zip_________________ City/St/Zip Identification of Source Phone#:_________ Fax#: Collection Point 5 -i J <-' i CA, CH. BP 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) Volatile Halocarbons (524) Purgeable Aromatics (624/8260) 2. 2. Coliform P/A (public supplies) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) f 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 £^.-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) L^rPesticides (525) 10. Glycols in Water Refrigerated? .yes. .no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) J 2. Base Neutral Extractables (625/8270) Chlorinated?:yes. no 13. Diquat (549) QS. 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)
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INORGANIC ANALYSES REQUESTED - Lab#. (circle tests) ;3 1. Color 20. Acidify / 39. Aluminum 59. Potassium 2. Turbidity ^1. Alkalinity, as CaCOa I 40. Antimony Selenium 3. pH Bromide / Al. Arsenic Silver 4. Conductivity 2^3. Bromate/Chlorate/Chlorite I 42. Barium . Sodium 5. Corrosivity (temp: .°C) Chloride I46. 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 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N Calcium, Ca*^ 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N ■ 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 Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease I st. Copper 70. Disk Deliverables 14. Solids, Settleable 33. Phenol I 5a Iron TCLP 15. Solids. Suspended 34. Phosphorus. Total as P Lead 71. TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates Z^. Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37 Surtactants 1 5f. Mercury 74. TCLP-Volatiles Other: ________ 38. ! IV254 1 / 57. Molybdenum 59. Nickel 75. TCLP-BNA’s
NYC-WTC_000071049
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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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