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Chain of custody record with contact details, Westchester County

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

NYC-WTC_000071242–000071245

Folder label: “26991

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NYC 9/11 Public Portal Document Westchester aov.com ENVIRONMENTA- SERVICES SAMPLE SUBMISSIONFORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 12:55 e/Date Set: Sample Type (circle one): 1.Potable 3. Non Potable Treated 2. Non Potable 4. Other* Time/Date Collected: 450 Collected By: - D5 11-2-01 Agency Code: Collected From: Location's/Individual's Name_A-IC DEP Street 19 WeST LAKE DRIVE City/St/Zip Valhaclla, AN 10595 Identification of Source Collection Point CROGH _NÝS-ELAP No. 10108 Form A-70 (rev.1/96) Huk. TuelA 445, ПУТ, C 0414 9.501210,9938,134 Bottle#s:P_ F13-2074 254274 Chain of Custody? _ yes _no Comments: PWS #:. Source ID: . _Type Descriptor: Bill to: Name/Company Street City/St/Zip Phone#: Fax#: CA,CH, BI?. Check#: Amount$ BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYŞIS Lab#: (circle tests) 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A (public supplies) : 3. Coliform MPN (priv well, raw, stp) 4.Focal Coliform (all samples) 5. Microscopic acroscopic 8. Other: Refrigerated? Chlorinated:? Free Chlorine Res Total Chlorine Res: рH yes yes no no mg/L .mg/L Lab#: (circle tests) 1. .Trihalomethanes (524) Volatile Halocarbons (524) Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) 5. Microextractables (504) 6. Pesticides (507) C Pesticides/PCB screen (508) 8. PCB as Decachlorobiphenyl (508A) 9.Herbicides (515) Pesticides (525) Carbamate Peștiçides (531) 12. Glyphosate (547) :13. Diqyaty (549) 14. Chiorination Disinfection Byproducts (551) 15. Haloacetic Acids (552) 16. Pesțicides (SM18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) 18, Other:: 1. Purgeable Halocarbons (624/8260) 2. Purgeable Aromatics (624/8260). 3. Acrolein & Acrylonitrile (624) 4. . Phthalates (625/8270) 5. Organochlorine Pesticides (608/8081) 6. PCB's (Arochlors) (608/8081). 7. Methoprene (616) 8 Herbictdes (EPA1978/8151) 9. Pesticides, (SM18/6630) 10. Petroleum Hydrocarbon Scan (310-13) 11, Giycols 12. Acla Extractables (625/8270) Base Neutral Extractables (625/8270) 14 GC/MS Semivolatile Unknown Scan 15. Purgeable Halocarbons (DEF) 16. Purgeable Aromatics (DẸF) 17. Pesticides/PCB's (DEF) 18. Other: INORGANIC ANALYSIS REQUESTED - Lab# (circle tests) 1. Color a 20. Acidity 2. Turbidity 21. Alkalinity, as CaCO3 3. рh 22. Bromide 4. Conductivity 23. Bromate/Chlorate/Chlorite 5. Corrosivity (temp: °C) 24. Chlorde '6. BOD (5 day) 25. Cyanide 7. Soluble BOD (5 day) 26. Fluoride 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 9. Chemical Oxygen Demand 28. Nitrogön, Ammonia as N 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N MtsTotal Organic caroon 30. Nitrogen, Nitrite as N 12 Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 16 Solids, Percent (%) 32. Oil an Grease Solids, Settleable 33. Pheno Solids, Suspended 34. Phosphorus Total as P 6 Solids, Total 35. Phosphorus, Ortho as P Sollds, Total Dissolved 36. Sulfatos Solids, Total Volatile 37, Surfactants 12)OtherSa,Ti 38: UV254* 39 Aluminum JAntimony 41. Arsenic 42. Barium 43,Beryllium 44. Boron 45. Cadmium 46 Calcium, as CaCO3 Calcium, Ca*? 48.Chromium, Total 49 Chromium, Hexavalent ,Cobalt 51 Copper 32 lron 3.Lead Magnestum Manganese 56. Mercury: 57 Molybdenum 58. Nickel 59/Potassium 60. Selenium •61. Silver: Sodium Thallium Vanadium 65. Zinc CLP 66. Metals/CN 67. Volatiles 68. Semi-violatiles. 69. Pesticides/PCB's 70 Disk Deliverables TCLP 71.TCLP:Metals r 72. TOLP-Pesticides 73. TCLP:Herbicides 74 TCLP-Volatiles 75,TCLP BNAS NYC-WTC_000071243

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NYC-WTC_000071243Source: NYC Law Department, mirrored locally

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