NYC 9/11 Public Portal Document
TTEYB
ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM
30
WESTCHESTER COUNTY LABORATORIES AND RESEARCH
2 Dana Road: Valhalla, New York 10595.
((914) 593-5575
NYS-ELAP No. 10108
Form A-70 (rev./1/96
Time/Date Set:
Sample Type (circle one):
3 Potabie
:3. Non-Potable Treated
2 Non-Potable
4. Other
Time/Date Collected:
Collected By. Wagner
Collected From:
Location's/Individual's Name NyCDEP
steet 14 WestLake DAive
cıysızp Valballa, NY 10595
Identitication of Source
collection PonE CRO GH
PF6:7Ib P: 698P-w/00
QFG•SSs
0 5$79 556
otle #'s C.0480, K-7323n-95B3 4=b692
Chain of Custody?
yes
-no
11-4-01
Agency Code:
Comments:
PWS #:
Source ID:
Type Descriptor:
Bilto:
Name/Company.
Street
City/ŞțZip
Phone#:
Fax #:
CA, CH, ВІ?
Check#:
Amount$
BACTERIOLOGICAL ANALYSES
Lab#3
(circle lests)
1 Heterotrophic Plate
Count (hemodialysis & all others)
„Coliform PIA (public supplies) :
3 CoitormPN (priv well, raw, stp)
4. Fecal Colform (all samples):
5. Microscopic
6. Macroscopic
TLAPI
8. Other:
Refrigerated?
no
ORGANIC POTABLE ANALYSES
ORGANIC NONPOTABLE/SOLID ANALYSES
Chiorinated?:
yes
_yes.
Free Chlorine Res:
no
mg/L
Total Chlorine Res:
mg/L+
Lab #:
(drcle tests)
Trihalomethanes (524)
Volatile Halocarbons (524)
Volațile Aromatics (524)
4.Total Trihalomethane Potential (510)
5.
Microextractables (504)
Pesticides (507)
Pesticides/PCB screen (508)
PCB as Decachlorobiphenyi (508A)
Herbicides (515)
Pesticides (525)
.11. Carbamate Pesticides (531)
12. Glyphosate (547)
:13. Diquat (549)
14. Chlorination Disinfection Byproducts (551)
15. Haloacetic Acids (552)
16. Other Pesticides (SM-18/6630)
17. Petroleum/Hydrocarbon Scan (310-13)
1. Purgeable Halocarbons (624/8260)
2. Púrgeable Aromatics (624/8260)
3..
• Acrolein & Acrylonitrile (624).
4.3 Phthalates (606/8060)
.5. Organochiorine Pesticides (608/8080)
6. PCB's (Arochlors) (608/8080)
7. Herbicides (SM-18/6640; 8151)
8. Other Pesticides (SM-18/6630)
.9. Petroleum Hydrocarbon Scan (310-13)
10. Glycols in Water
11. Acid Extractables (625/8270)
Base Neutral Extractables (625/8270)
GC/MS Unknown Scan:
14. Purgeable Halocarbons (DEF)
15. Purgeable Aromatics (DEF)
16. Pesticides (DEF)
17. PCB's (Arochlors) (DEF)
INORGANIC ANALYSES REQUESTED -Lab#:
(circle tests)
1."Color
2: Türbidity:
3.оH:
4.
Conductivity
5. . Corrosivity (temp:.
°C)
BOD (5 day):
TSoluble BOD. (5 day)
8. Carbonaceous BOD (5 day)
9,
Chemical Oxygen Demand
10. Dissolved Oxygen
11. Total Organic Carbon
12. Total Organic Halides
13. Solids, Percent (%)
14. Solids; Settleable
15, Solids, Suspended
16, Solids: Total:
17. Solids, Total Dissolved
18. Solids. Total Volatile:
Othert Z
‹20. Acidity
*21. Aikalinity, as CaCO3
Bromide
23/ Bromate/Chlorate/Chlorite
241 Chioride
25. Cyanide
26. Fluoride
27. Hardness, Total as CaCO3
28. Nitrogen, Ammionia as N
29. Nitrogen, Nitrate as N
30. Nitrogen, Nitrite as N
31. Nitrogen, Total Kjeldahl as N
32. Oil and Grease
33. Phenol
34. Phosphorus. Total as P
35. Phosphorus, Ortho as P
36. Sulfates
37. Surfactants
38,UIV254
Shus
39
Aluminum
Antimony
Arsenic
Barium
Beryllium
44.
Boron
45. Cadmium
46
Calcium, as CaCO3
Calciüm, Cat2.
Chromium, Total
49
Chromium, Hexavalent
Cobalt
Copper
iron
53.
Lead
(54) Magnesium
5 Manganese
Mercury"
57 Molybdenum
58. Nickel
Mất
Potassium
60.
Selenium
61
Silver
Sodium
Thallium
(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
NYC-WTC_000071386
007
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