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
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Time/Date Set:__________ WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914)593-5575 NYS-ELAP No. 10108 Form A-70 (rev. 1/96)
Sample Type (circle one): 1 .• Potable 3. Non-Potable Treated Bottle #’fe:_: 2. Non-Potable 4. Other______________ Chain of Custody? yes no /• Comments: Time/Date Collected:. Collected By: Agency Code: PWS #:__________ Source ID: Type Descriptor:
Collected From: Bill to: Location's/lndividual's Name, Name/Company Street____________________ Street___________ City/SVZip________________ City/St/Zip Identification of Source Phone#: Fax #:. Collection Point ! I CA, CH, Bl? Check#: Amounts
BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:_________________________ Lab #:_________________ ______________ (circle tests) (Circle tests) ' i . .. 1. Heterotrophic Plate 1. .Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) ■^'Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) 4. Total Thhalomethane 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.S Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) -iifl^esticides (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) Chionnat’ed?: .yes. no 13. Diquat (549) 13?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)
k INORGANIC ANALYSES REQUESTED - Lab#: r (circle tests) / / 1. Color 39^ 59. Potassium 20. Acidity Aluminum 2. T urbidity 21;. Alkalinity, as CaCOs ' 40 Antimony 6O.'''Selenium 3. pH 22. Bromide pl Arsenic 61. Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite Barium 62. Sodium 5. Corrosivity (temp: .°C) 24; Chloride Beryllium 63. Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65.~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 47. Calcium, Ca*^ 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N . 48. Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromiupn, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kieldahl as N 50\ Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 51. Copper 70, Disk Deliverables 14. Solids, Settleable 33. Phenol 52.Tron TCLP 15 Solids, Suspended 34. Phosphorus. Total as P S3,-Lead 71.TCLP-Metals 16. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55.; Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37 Surfactants 56.' Mercury 74. TCLP-Volatiles 19. Other:____ 38 I.IV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel
NYC-WTC_000071052
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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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