Chain of custody record, Westchester County Labs

NYC 9/11 Public Portal Document

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'IIIY Y iNWRONMedrAL SERVICES SAMPLE SUBMISSION FORM UU ' 2 Dana Road, Valhalla, New York 10595 liJ8«fchost^tounty , . -,(914)593-5575 NYS-ELAP No. 10108 Time/Date Set: __________ _ _____________________ . ■_____________ FormA-70 (rev. 1/96) V-'O Sample Type (circle orie): ■ - "————p S sSf /iO J) Potable - 3. Non-Potable Treated • ^ttle r ______ —

2. Non-Potable 4. Other_______ _ ________________ Chain of Custody?___________ yes no Time/Date Collected: ________ Comments;__________________________________________ ;___ -i Collected Bv: T . . Agency Code:_______ - PWS #: Source ID: Type Descriptor: ■)

Collected From: Bill to: Location’s/lndividual’s Name tOM C XXx fi , . Name/Company

(^j^VZip Valhgkbo City/SVZip_

Idehtific^ion of Source . • ■ ■:■■■’. . ■ ■ ■ .- _ Phone#:_ 'Fax#:_ Collection PointXXxXZ^^£iZZY~~_~T7?~_3_j_2_ | CA, CH, BI?_ Check#:.. . Amounts.

BACTERIOLOGICAL ANALYSES / ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#:__________ ;_________ Lab #;_______________________ (circle tests) / (circle tests) k /' /. .J; Heterotrophic Plate 1. Trihalomethanes (524) V Y 1, Purgeable Halocarbons (624/8260)

i ‘5 >Y ,G<xiht;(herhddfe Volatile Halocarbons (524) ; 2. Purgeable Aromatics (624/8260) 2, Coliform P/A (public supplies) Volatile Aromatics (524) 3. ' Acrolein & Acrylonitrile (624) ..t ■ MPN'lpriV well,)raw^ 4. Total Trihalomethane Potentiat (510) / ; .4/' Phthalates (606/8060) ;4;'Fecal Coliform (all samples)’: 5., Microextractables (504) i ; drganochlbrine Pesticides (608/8080) ■'i

5) Microscopic Pesticides (507) ; 6/ i pCB's (Arochlors) (608/8080) / 6. Macroscopic Pesticides/PCB screen (508) < 7. / Herbicides (SM-18/6640; 8151) 7. API ‘ ' > 8; ■ PCB as Decachlorobiphenyl (508A) Y; 8/ Other Pesticides (SM-1^ U, , y8rbthbiXXd£YYkMX£Y^ ;y ^9. Herbicides (515) 9; JPetrpleum Hydrocarbon Scan (310-13)' Pesticides (525) Y\1 (j; GlycblA in \A/ateh^;'^ Y ,/ ‘.■/'■r . .iU' : .Refrigerated?;U 2^eAY Ji6‘> ’( Carbamate Pesticides (531) 1 i: Acid Extractables (625/8270) 2. Glyphosate (547) Base. Neutral Extractables (625/8270) Ghlbnhatedf?:' Y ; yes -'no: Y n^piqtJat (549). ' . . GC/MS Unknown Scan YYSYYYi/'^’/Y Y Y Y-X, 4‘. Chibrihation Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine Res;l^ ' ^mo/L / "d 5. Haloacetic Acids (552) ' 15. Purgeable Aromatics (DEF), vf6. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) Total Chlorine Res:^:i£^ mg/Lt M7. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF) s 1 .Y \ _________________ V a i X INORGANIC ANALYSES REQUE^^ Jb#:ZZ 't

(circle tests) / 1.' Color ’ ■ ' 39. Aluminum '<^59. Potassium 2/ Turbidity. MyAntimony 60. Selenium '3; pH ...22) Bromide 4l. Arsenic 61. Silver J 4. Conductivity /2^’ Brpmate/Chlorate/Chlorite 42. Barium (_62; Sodium 5. Corrosivity (temp: .°C) 2^ Chipride /43} Beryllium , 63. Thallium 6. BOD (5. day) 2Sc^dnide, >4. Boron /64j Vanadium 7; Soluble BOD (5 day) 2^ Fluoride ■ - 45. Cadmium /felZinc \8y Carbonaceous BOD (5 day) 27. Hardness, Total as GaCOs 46. Calciurri. 'as CaCOa CLP J9. Chemical Oxygen Demand 28. Nitrbgen, Ammonia as N (4^Calcium, Ca*2 66. Metais/CN 1.0. Dissolved Oxygen 29. Nitrogen, Nitrate As N "48. 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, U 69. Pesticides/PCB's 3, .^lidst Percent (%) * . 32. Oil and Grease - 51. Copper 70. Disk Deliverables Solids;) Settleable/- Y 33. Phenol ■ <, (5g) Iron . ,;k ISLE 115, Solids, Suspended /. 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals SlASi^(!dS,:Tpta!;.Y. . 35. Phosphorus,, Ortho as P . Magnesium Y 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates .. Manganese/ ' 73^TCLP-Herbicides , X Sblids..Total Volatile i/Y' Y37Y Surfactants) . Mercu^YYuY 74. TGLP-Volatiles _ 38. LIV254 ■ Molybdenum ;75.:TCLP-BNA’s Y ' 58.1 Nickel, J

NYC-WTC_000071361