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Chain of custody record with contact details, Westchester County

Machine-extracted title · confidence 95%

Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research including contact information.

NYC-WTC_000071184–000071191

Folder label: “26982

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NYC 9/11 Public Portal Document ...... .. ...............

8 ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 1..V* (914) 593-5575 NYS-ELAP No. 10108 Time/Date Set:_____ ______ Form A-70 (rev. 1/96) Sample Type (circle one): V *5 S S, ' 1. Potable ) 3. Non-Potable Treated Bottle #’s:. k- .VH '2?TjorbT’otable 4. Other____j_____ V 3.C7 Chain of Custody? .yes .no Time/Date Collected:__l_’_l-i2J_i-ll^___ i__ ) I’ Comments: Collected By:__ i ■■ Agency Code: PWS #:_________ .Source ID:. Type Descriptor.. Collected From: Bill to: I* .. ' ' IV-'J Location's/lndividual’s Name. Name/Company Street__________________ Street__________ City/SVZip______________ City/St/Zip Identification of Source Phone#: Fax #: Collection Point*": O C? I CA, CH, Bl? Check#: Amounts

BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLIO 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) 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 Trihalomethane Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic 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. Olher:____j_____________ 9.-Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) ;' (^Pesticides (525) 10. Glycols in Water Refrigerated? yds. 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) ^J3C/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free (Jbtofih^es:. mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) 16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) (^otal Chlorine Res: mg/L 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB's (Arochlors) (DEF)

INORGANIC ANALYSES REQUESTED - Lab#:. (circle tests) 1. Color 20. Acidity 5PS? 39. Aluminum 59. Potassium . 2. T urbidity 21. Alkalinity, as CaCOa 40. Antimony 60. Selenium : 3. pH 22. Bromide 41. Arsenic 61. Silver I, CO 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium ' I 5. Corrosivity (temp: .°C) 24. Chloride 43. Beryllium 63. Thallium j 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium | 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc_____ L_ 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOs 46. Calcium, as CaCOs 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, Nitrile as N 49. Chromium, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pesticides/PCB's 13. Solids, Percent (%) 32. Oil and Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleabie 33. Phenol 52. Iron TCLP 15. Solids, Suspended 34. Phosphorus. Total as P 53. 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:____ ________ 38.1.IV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel

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