Chain of custody form, Westchester County Labs

NYC 9/11 Public Portal Document ... Ai'?-r/'- r-, -.4 ■ • ENyiRONMENTAL:;SERVICES.SAM^LE;.^^^ « .. WESTCHESTER'CO.UNTYYABORATORIES ’ANb RESE^^ *' 1 I 'Y‘ - ■; 2 D'aria' Road; Valhalla, New York"'10595 , “'.{914)'593-5575 —■’aw U NYS-ELAP No? 10108-. i/Date Set: Form A-7d' (rev.1/96)'^ . • / . / Sample Type (circle one): ■ 1. Potable^^ '3. Non Potable Treated Bottle #’s:^ - ' . •_______ > " ■ '^brNo'n Potable 4. Other _____ ■ Chain of Custody? ’ ■ yes ' no ' Time/Date Collected: Comments: Collected By: _ Agency Code: PWS #:______ 1 Source ID: Type Descriptor: Collected From: Bill to: Location’s/lndividual’s Name f Name/Company Street Street________ City/St/Zip City/SVZip Identification of Source__________________________ Phone#: Fax#: Collection Point />f/") A /-i_______________ CA.CH, Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#: ________ ___ Lab#: __________ (circle tests) (circle tests) 1. Heterotrophic .Plate < 1.,Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) Volatile halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN' (priv well, raw, stp)' 4\Total Trihalor^thane"Potehtial (510) 4. Phthalates (625/8270)^ '' 4.. Fecal Coliform (all samples) 5. Microextractables (504) 5.’ Organochlorine Pesticides (608/8081) 5. Mici;oscopic ’6;.^stidd^,(^’ 6. - PCB’s, (Arochlors) (608/8081) ||H|croscopic © Pesticjdes/RCB^sbreeiTJSOS); . 7/ MettTbprehe.(616) , ■8?.PCB\s" DecachlorobiphenyI>(508A)’ 8?, Herbicides (EPAI 978/81'51) 8. Other: >^Herbi^s?(51^ 9j Pesticides (SM.18/6630)’ l6*,.Petroleurn Hydrocarfion Scan (310-13) ; Refrigerated? yes___ no 11’Carbamate,Pesticides; (531)? llr.Glycols Chlorinated:? yes no 12. Glyphosate; (547), •'12. Acid Extracfables (625/8270) 13.-Diquar^49)^ . Base^Neutfal.EiSfactable's' '(625/8270)’ ---------------- ---------- Free Chlorine Res:. ________mg/L 14.. Chlorination Disinfection Byproducts (551)’ (^.GC/MS SemivolaJile Unknown Scan, 15. Haloacetic Acids (552) 15, Purgeable Halocarbons'(DEF) Total Chlorine Res: _______ mg/L 16. Pesticides (SMI8/6630) lO.-Purgeable Aromatics (DEF) pH 17. Petrble'umVHydrocarbon' Scan (310-13) 17." Pesticides/PCB’s, (DEFf 18. Other:'' ~ ' 18.Other" -.‘a

INORGANIC ANALYSIS REQUESTED - Lab#: LW (circle tests) ■/ . 1. Color 20. Acidity ,3?^ Aluminum <?59.;Potassium 2. Turbidity 21. Alkalinity, as CaCOs ?4q;Antimony r^O. Selenium 3., pH ■22. Bromide • - . 41. Arsenic 61. Silver ; 4. Conductivity 23, Bromate/Chlorate/Chlorite ■*''4Z Barium . \ bg^odium' 5. Corrosivity (temp:j®C) .24. Chloride <^3?Beryllium • . Y* • ‘ k^Thallium ' 6. BOD (5 day) 25. Cyanide 44. Boron .j '. ^64^anadium -.7. Soluble BOD (5 day) 26? Fluoride 45. Cadmium ‘ . ?'65.' Zinc'. 8. Carbonaceous BOD (5 day) 27. HardneU, Total as CaCOs 46^Calcium. as'CaCOs ■ •' CLP - ■ 9. Chemical Oxygen Demand 28.* Nitrogen,?Amiponia as N) ■’ ^^Calcium? Ca/^. ’•f 66. Metals/CN' 10. Dissolved Oxygen’ '^>Nit.r^en7.Nitrate;as: N.. 48. Chromium,i4ota[-■ ? / ‘eTAVoiatiles’’ , 11, Total Organic Carbon 30., Nttrogen,^Nitrite.as.N. . • 49.,Chromium, Hexavalent ;68. Semi-violatiles, 12/Total Organic Halides, '3V»Nitrogeh?Total Kjeldahl as.N ’, (gQ^Cqbalt,! '^?^sticides7RCB’s. ■d^Sdlidq' Percent ‘ (%) J ■ 32:ON'an^Greaseb ' ^t^p^rz j70>pisk'‘Deliverables2 ^^olids, Settleable.. 33)Phehob f ' 3^4; gKosph'ontkT31a? as R? ?53 .Lead, lECLP) .^^Solids, Suspended^ . i J16; Sdli^s/I(^l^ 35?.PhospiTbi;ijs,C^hq;as;p?' / 54^agnesiurh/ I 1 l/cSolids.’-Totar Dissolved . 36>.Sujfates> “ ’ V^Manga ’neseq .73?TCtl^-Aerbici^^ ■■18,? Solids,'-Total Volatile; 37A-SurfactantS) se^M^citW j74..TCLP-V6latiies, ’ I ^^Mol^iiumJ i?W. Other. . J75)TGLP-B!^S;. J ■ - ;L-.58?Nicgg) v** .« . . .. ?

NYC-WTC_00b071877 ■