Chain of custody record, Westchester County Labs

NYC 9/11 Public Portal Document

' ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH Ulf . 2 Dana Road, Valhalla. New York 10595 - . (914)593-5575 NYS-ELAPNo 10108 TTme/DateSetL^l__________________________________________ . _ Form A-7g (rev^ 1/i^j

Sarnple Type (circle one); ' ' ; - '■

Potable . ■ 3. Non-Potable Treafed 2: Non-Potable 4. Other j Chain of Custody?yes no Time/Date CbllectedY-' . : Commehts:_2___^ Collected By: <■■. * Agency Code:___ nVPW.S Source ID: - Type Descriptor: Collect^ From: , Bill ta 3 Lbcatidn's/rndivlduars Name C . Name/Company Street iM. L>r_____________ .•■'' StreerY£<;_j;2_2L. ' Ci^zst/7ip ValKififlU bjy k . Citv/St/Zip ? Identification of Source ____ ——- ■ y Phone#:? ? ' Fax#: '.(^ifetioriPoinr.. 4^ H ■■■ - -■: '• - ?' ; ' rCA,CH. Bl?: Check#: - '■ Amounts.

bacteriological analyses ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab

?! (circle tests) ' 1 . Heterotrophic Plate 1. Trihalomethanes (524) 1-. Purgeable Halocarbons (624/8260) ' -t/Gount (hemodialysis & all others) 1''^ Volatile.Halocarbons(524) 2. Purgeable Aromatics (624/8260) - 2. Gbliform P/A (public supplies) •Jx Volatile Aromatics. (524) 3. Acrolein & Acrylonitrile (624) ?3;?i5^ifprrn MPN (priy well,, raw, stp) 4. Total,Trihalomethane Potential (510) ■ ' 4; Phthalates (606/8060) ? ?; ' ■ > ■'I 4;.Fec3l Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) < ?; 4 Pesticides (507) ;. , / 6/ ’PCB's (Arochlors) (608/8080) 3 5; Microscopic , ^BM^crpscopip-? - ■ t:? ,< Pesticides/PCB screen (508). ? 7, Herbicides (SM-18/6640; 8151). . 7. API 8. PCB as Decachlorobiphenyl (508Aj < 8. Other Pesticides (SM-18/6630)' 9^ Herbicides (515) . • Y 9. /Petroleurft Hydrocarbc^Scan (310-13) O O-Feticides (525) tO.'Glycdlsjh Water; ■ Refrigerated? yes no ?11. Carbamate Pesticides (531) 11 Acid Extractables (625/8270) 12. Glyphosate (547) tgk Base hieutral Extractables (625/8270) ■■fl

Chlorinated?: yes. .no Y. ? 13. Diquat (549) Q^GG/MS Unknown Scan '■ . .-4 i4; Chlorination Disinfection Byproducts (551). 14. Purgeable Halocarbons (DEF) Fris^' Chlorine Res:__ .mg/L i .-Is. Haloacetic Acids’(552) 15. Purgeable Arbrnatics (DEF) '.16. Other Pesticides (SM-18/6630) 16.'Pesticides (DEF) ;tpt4,Chlorine Res: -- mg/L i. a17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF) 4

~4~7 "MrGANIC analyses request^ $.ab#:. (circle tests) "R ' i. . C.Plor Z/.Turbidity . 26? Aridity 2ii Alkalinity, as CaCOs 39. Aluminum (Si Potassium /40) Antimony 60. Selenium ;3fbir<' Y . ;MBi^ide ^4^. Arsenic 61. Silver C ■ 4. . Conductivity 23? Bromate/Chlorate/Chlorite 42. Barium /J2. Sodium E '5,'. Gorrosivily (temp:______ °C) 24iC|jl6ride Beryllium Thallium " ^6/'/BOD (5 day) . .. i2^iC^nide 44. Boron Vanadium | 7.-. Soluble BOD (5 day) '26. Fluoride 45. Cadmium 65. Zinc I. 8; ; Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOs ^6. Calcium, as CaCOs CLP ^9. Chemical Oxygen Demand , 28. Nitrogen, Ammonia as N Calcium; Ca*^.. <..... ' 66. Metals/CN '^io.:.Dissolved Oxygen y: v 29. Nitrogen, Nitrate as N 3 48. Chromium, Total, 67. Volatiles i t.'total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromium, Hexavalent . 68. Semi-volatiles 12. Total Organic Halides ■• 31. Nitrogen, Total Kjeldahl as N (5jS». Cobaft 69. Pesticides/PCB's : 13. Solids, Percent (%) , 32. Oil and Grease 51. Copper 70. Disk Deliverables 14. Solids, Settleable; 33. Phenol , Iron ISLE 15. Solids, Suspended ■ 34. Phosphorus. Total as P . Lead 71.TCLP-Metals .16.-Solids, Total . 35. Phosphorus, Ortho as P (^4; Magnesium 72. TCLP-Pesticides • 17."solids. Total Dissolved 36. Sulfates : ■ / Manganese 73. TCLP-Herbicides 37. Surfactants ■ - 56. Mercury . : • ; 74. TCLP-Volatiles ’ 38.IJV254 ^7? Molybdenum ' :75.tTCLP:BNA’s ; ; ■<

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