NYC 9/11 Public Portal Document
!r
.'7^... ‘ - '.
/ENyTRQWENJALyjSEBiZlGTStWMS^^
ID
.'jWe/bate,’Set:..Z
I <jyEtrCHESTEQ$'6.Ul^i;/AB):>R7$Xb'BI^
-
■ -;2bana Rp^.iVallial!a,<Ne;wYprkY0595
. i T(gn^y'593-^^-
' .
S'
•
z• .'HW
'NYS-ELAPNo.^0Y08'
. Form A-70 (rev. 1/]
^^XanfRfe^pe^(circie one): j'j-I- J
i'
''\iyPptable.. “ . • ...i <3., .Non-Potable Treated , ' ( Bottle -
I^Non-Potable .4."Other , ; /• Chain of Custody? ' yes no
•^Tirhe/Date'CpIjec^ - ■ Comments:
(cbllected.By:'7)''<'S Z ' Agency Code: - - PWS #:___________ Source ID: Type Descriptor:
(Collected From: ■■ Bill to:
'• Location’s/lrldfy^dual’s. Name ■ /v V (.• ________ __ Name/Company
■'.Street f ' >>rlt u f -______ ' Street■
citv/s'^zio Ha Ho ' '• k' r 5 Citv/St/Zip
' Identification b'f Source-' ' ' ___________ U___ Phone#;__ _______ Fax #:.
:Collection^oint?^- Y.t'I -f A I CA. CH. Bl? Check#: Amounts,
'BACTERIpLOGJCAU ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES
<Lab#; ■ / ‘ ' ; Lab #:_2____ L_^__
(drclel'Ulsj ... yA. ' (cirdelests) - ■
■,i; Heterptrophic'RIate/'; (■ ' ’-;1'. ^Trihalomethanes(524) 1. Purgeable Halocarbons (624/8260)
' CpuhV(.KerTibdialysiS/&'al^ others)' /A Volatile Halocarbons (524) . 2.' Purgeable Aromatics (624/8260)
(2, , Volatile Aromatics J524) ’3. Acrolein & Acrylonitrile (624)
V3..?Col]fprrn/M^N'(pciytweljVraw.; stp)' iTotaTTrihalomethane Potential (510) '• •4. Phthalates (606/8060) .
. 4'.' Fecal Goliform^falijsdmples): < "5. Microe^ractables (504) ' - 5. .'Organochlorine Pesticides (608/8080)
'^5? Microscopic" '■ ^\Pesticides?(507) ■ 6. PCBls (Arochlors) (608/8080)
■6; Macroscdpic '’ -j . ,•• . Gt Pesticides/PCB screen (508) 7. .Herbicides (SM-T8/6640; 8151)
■Qmer:. •-.J.ti' ' • .8. iPCB as Decachlorobiphenyl (508A)- 8. Other Pesticides (SM-18/6630)
■)l ' Herbicides (515) ‘ 9. .Petroleum Hydrocarbon Scan (310-13)
Pesticides (525) 16. Glycols in Water .
■.RefriQerated?j ' ?■ yes^- _no', . 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270)
12. Glyphosate (547) ■ ‘ 12. Base Neutral Extractables (625/8270) ■
; Chionnate'd?;p'yes -' ■- no ■ 13. Diquat (549) 0/ GC/MS Unknown Scan .
14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF)
' Free Chlorine Res: ' mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) * .
16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF)
Total'Chlorihe Res: ' rng/L 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF)
'pHl. /I
Z' / / / A?/—
J ■ ■- .>
INORGANIC ANALYSES REQUESTED - Lab#:
(circle tests)
1. Color ■ 20. Acidity 39. Aluminum 59: Potassium
2.. Turbidity 21. Alkalinity, as CaCOa ^40? Antimony 60. Selenium
3. pH . 22. Bromide 4'1. Arsenic 61. Silver
4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium ('62; Sodium
5. Corrosivity (temp: .’C) 24. Chloride (43.. Beryllium .^3; Thallium
6. BOD (5 day) 25. Cyanide 44. Boron /64.'Vanadium
7. . Soluble BOD (5 day) ... 26. Fluoride 45. Cadrhium 65. Zinc
8. ' Carboriaceous BOD (5 day) 27. Hardness. Total as CaCOa 46. Calcium', as CaCOa CLP
9. Chemical Oxygen Demand ' 28. Nitrogen. Animonia as N ' 47? Calcium. Ca*2. 66. Metals/CN
10; Dissolved Oxygen 29. Nitrogen. Nitrate as N ~48. Chromium. Total 67. Volatiles
!. 11. Total Organic Carbon 30. Nitrogen. Nitrite as N 49. Chromium. Hexavalent . 68. Semi-volatiles
12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N (5.0*. Cobalt . 69. Pesticides/PCB’s
J^Solids. Percent (%) 32. Oil and Grease 51. Copper' 70. Disk Deliverables
^wfeolids. Settleabie 33. Phenol . (52.'-lron TCLP
-..15;-S6lids, Suspended 34. Phosphorus. Total as P 53.' Lead ‘ .71.TCLP-Metals
16. Solids. Total > 35. Phosphorus. Ortho as P ( 54^ Magnesium • 72. TCLP-Pesticides
,^1^7. Solids.'Totaj Dissolved: 36. Sulfates 1'55;' Mangariese 73. TCLP-Herbicides
r/8.^Sblids.'‘fotal Volatile'’ , 37.' Surfactants ' " . • 56. Mercury j* ■ 74. TCLP-.Volatiles: '
^fg^pther:. 'ArfTi ‘38. I IV254“ -• ,5575 Molybdenum (TS.frcLP-BNA's i
'587Ni6keL, ' ”
.1
NYC-WTC_000072142
OCR can misread numbers and units. Confirm readings against the page image before using them.