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Chain of custody record, Westchester County Labs

Machine-extracted title · confidence 85%

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

NYC-WTC_000071383–000071386

Folder label: “27113

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Scanned page image, NYC-WTC_000071384
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NYC 9/11 Public Portal Document ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 1 2 Dana. Road, Valhalla, New York 10595 (914) 593-5575 ie/Date Set: Sample Type (circle one): Potable 3. Non-Potable Treated 2/Non-Potable 4. Other Time/Date Collected: Colected By: Wogner 1/41 Agency Code: Collected From: Location's/Individua's Name MYC DEe Street 19 Westloke cıyisvzip Valhalla, Ny los9s Identification of Source Collection Point Cat Le C4 Botle PeSR- Chain of Custody? Comments: PWS #: Bil tọ: {Name/Company Street :City/SV/Zip Phone#: CA, CH. BI? miyes no Source, ID: BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES Lab# (circle tests):VA 1. Heterotrophic Plate Count (hemodialysis & all others) 2, Coliform P/A (public supplies) 3 Coliform MPN (priv well; raw, stp) 4 Fecal Coliform (all samples) 5. Microscopic 6. Macroscopic 7 AP" 8. Other: Refrigerated? yes. Chiornated?:_ _yes_ :no. Free Chiorine Res: _mg/L Total Chlorine Res: mgL: Lab# (drcle tests) Trihalomethanes (524), Volatile Halocarbons (524) Volatile Aromatics (524) Total Tnhalomethane Potential (510) 5. Microextractables (504)* Pesticides (507) Pesticides/PCB screen (508) PCB as Decachlorobipheny| (508A) Herbicides (515) Pesticides (525) : Carbamate Pesticides (531)) 12. Glyphosate (547) 3. Diquat (549) 14. Chlorination Disinfection Byproducts (551) 415. Haloacetic Acids (552) i16: Other Pesticides (SM-18/6630) 17. Petroleum/Hydrocarbon Scan (310-13) INORGANIC ANALYSES REQUESTED-Lab#:_ (circle tests) 2713 1 Color 20, Acidity 2.- Turbidity 21% Alkalinity, as CaCOs 3 pH 22, Bromide 4. Conductivity 23, Bromate/Chlorate/Chlorite 5. Corrosivity (temp °C) 4, Chloride 6. BOD. (5 day) 25. Cyanide Soluble BOD (5 day) 26. Fluoride 9: Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 Chemical Oxygen Demand 28. Nitrogen, Ammonia as N: 10, Dissolved Oxygen 29. Nitrogen, Nitrate as N 1l. Total Organic Carbon 30. Nitrogen, Nitrite as N. 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 13: Solids, Percent (%) 32. Oil and Grease 14. Solids, Settleable 33. Phenol 15. Solids. Suspended 34Phosphorus, Total as P. 16. Solids, Total, 35. Phosphorus, Ortho as P 17: Solids Total Dissolved 36. Sülfates 18-Solids Total Volatile 37 Sürtactants 419 Other. 38 UV254 39. Aluminum Antimony Arsenic 42 , Barium Beryllium "Boron 45. Cadmium 46. Calcium, as Caco" 7l Calcium, Ca" 48. Chromium, Total 49. Chromium, Hexavalent (50. Cobalt 51 Copper . Iron 53. Lead 4. Magnesiüm Manganese Mercury 2 Molybdenum 58 : Nickel20 NYC-WTC_000071384 NYS-ELAP No. 10108 Form A 70 (rev. 1/96) toldaana _Type Descriptor: ¿Fax #: :Check# •Amount$. ORGANIC NONPOTABLE/SOLID ANALYSES 1, Purgeable Halocarbons (624/8260) 2 Purgeable Aromatics (624/8260) Acrolein & Acrylonitrile (624) 4 Phthalates (606/8060): Organochlorine Pesticides (608/8080) PCB's (Arochlors) (608/8080) 7 Herbicides (SM-18/6640; 8151) 8 9 Other Pesticides (SM-18/6630) Petroleum Hydrocarbon Scan (310-13) 10. Glycols in Water 11. Acid Extractables (625/8270) Base Neutral Extractables (625/8270) 6GC/MS Unknown Scan 14. Purgeable Halocarbons (DEF) 15. Purgeable Aromatics (DEF) 16. Pesticides (DEF) 17. PCB's (Arochlors) (DEF) 59) Potassium 60. Selenium 6.1. Silver 62 Sodium :Thailium 64) Vanadium 65. Zinc CLP 66. Metals/CN 67. Volatiles 68. Semi-volatiles 69. Pesticides/PCB's 70. Disk Deliverables ICLP 71. TCLP-Metals 72. TCLP-Pesticides 73. TCLP-Herbicides 74. TCLP-Volatiles .75. TCLP-BNA's

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NYC-WTC_000071384Source: NYC Law Department, mirrored locally

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