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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_000071406–000071409

Folder label: “27116

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Scanned page image, NYC-WTC_000071409
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NYC 9/11 Public Portal Document ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM 56 WESTCHESTER COUNTY LABORAȚORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 ((914) 593-5575 Time/Date Se Sample Type (circle one): Potable 3. Non-Potablé Treated 2: Non-Potable: 4. Other Time/Date Collected: 0905 la1l5.01 Collected By D: 3 Col Agency Code: Collected From: Locations/individuals Name_ NY C. DEP Street PWIeLt LAKE DRIVE City/St/Zip VACHALLA, NY. 10095 Identitication of Source collection Point.5 CATLEFE O 0Y NYS-ELAP No. 10108 Form A-70 (rev: 1/96) Botlo rs C.0464 6477, 5302/ ковоч косао 6382 2278 Chain of Custody? K86331K vecuan Comments: BLANK PWS #: Source ID: Type Descriptor: Bill to: Name/Company : Street City/St/Zip Phone#: Fax#: CA, CH. ВІ? Check#: Amount$ BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES Lab#: (circle tests) 1. Heterotrophic Plate • Count (hemodialysis & all others) 2 Coliform PIA (public supplles). 3. Coliform MPN: (priv, well raw, stp) 4. Fecal Coliform (all samples) 5. Microscopic 6, Macroscopic 7.APF 8. Other. Refrigerafed? yes • no Chionnated?+yes Free Chiorine Res: no mg/L Total Chlorine Res: mg/L Lab #: • (circle lests) Trihalomethanes (524) Volatile Halocarbons (524) Volatile Aromatics (524) Total Trihalomethane Potentíal (510) Microextractables (504) 6. Pesticides (507)2 Pesticides/PCB screen (508) PCB as Decachlorobiphenyl (508A) 9: Herbicides (515). 10 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. Purgeable:Aromatics (624/8260): 3. Acrolein & Acrylonitrile (624) 4. Phthalates (606/8060). 5. Organochlorine 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) KGCMS Unknown Scan Base Neutral Extractables (625/8270) 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 Turbidity 3. 4:: Conductivity 5. Corrosivity (temp: °C) 6. .BOD (5 day) 7. Soluble BOD (5 day). :Carbonaceous BOD (5 day) 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 1i Solids, Total Volatile pther Sa 20. Acidity 21. Alkalinity, as CaCO3 22. Bromide 23. Bromate/Chlorate/Chlorite 24. Chloride 25. Cyanide 26. Fluoride- 27. Hardness, Total as ÇaCO3 28. Nitrogen, Ammonia 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. Surtactants 38. UV254 27118- 39. Aluminum 40. Antimony 41. Arsenic 42. Barium 43. Beryllium 44. Boron 45. Cadmium 46. Calcium, as CaCO3 A7-Calcium, Cat2 48. Chromium; Total: 49. Chromium, Hexavalent (50 Cobalt: 51. Copper 52,/ron : 53. Lead : 54, Magnesium 55-Manganese 56. Mercury $57 Molybdenum 158. NickelC31 meteto 59.Potassium 60. Selenium 61.Silver {62 Sodium _63-Thallium 64.Vanadium 65. Zinc CLP 66. Metals/CN 67. Volatiles 68. Semi-volatiles 69. Pesticides/PCB's 70. Disk Deliverables TCLP 71. TCLP-Metals 72. TCLP-Pesticides 73. TCLP-Herbicides 74. TCLP-Volatiles 75. TCLP-BNA'S NYC-WTC_000071409

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NYC-WTC_000071409Source: NYC Law Department, mirrored locally

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