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Chain of custody record, Westchester County Lab

Machine-extracted title · confidence 95%

Document tracking the chain of custody for samples submitted to the Westchester County Department of Labs & Research.

NYC-WTC_000072226–000072229

Folder label: “26710

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Scanned page image, NYC-WTC_000072229
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NYC 9/11 Public Portal Document 235977727 ENVIRÖNMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH. 2 Dana Road, Valhälla; New. York,10595 ; .(914) 593-5575 NYS-ELAP, No. 10108 me/Date Set: Samplę Type (circlo one): Potable" : 3. Non Potable Tréated 2 Non-Potable 4. Other, Time/Date Collected: 915 tia?lrfs Collecied By: :NE:VMN Agency Code: Collected From: Location's/Individual's Name: NYCDEP /KENSiO Street VVNESTLL DRIVE City/SVZip= VALHAUA N!M Identification of Source Collection Point : CROGH/ Form A-70 (rev.:1/96)1 6-2015) 02763005324949, Bottle #'s: 440g8-10j400 Chain of Custody? ! _yes_ no "Comments: PWS #:_ Source ID:_ _Type Descriptor: • Bill to: Name/Company 10575 Street City/St/Zip Phone#: Fax #: CA, CH, BI? Check#: Amount$ BACTERIOLOGICAL ANALYSES Lab#: (circlè tests) 1.Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A:(public supplies):: 3: Coliform MPN (priv well, raw; stp) 4. Fecal Colitorm (all bamples) :5. Microscopic •6: Macroscopic ther:. Refrigerated?*2A _yes Chiörnấted?: -yes Free Chiorine Res: Total Chlorine Res: pH no no mg/L mg/L ORGANIC POTABLE ANALYSES Lab #: • (circle tesls) 1 Trihalomethanes (524) • Volatile Halöcarbons (524) Volatile Aromatics (524) .Total Trihalomethane Potential (510) •Microextractablés (504) Pesticides (507),- Pesticides/PCB screen (508) 8 PCB as Decachlorobiphenyl (508A)• Herbicides (515): C Pesicides (525) Carbämate Pešticides (531) 12: Glyphosate (547). *13 Diquat (549) i4. Chlorination Disinfection Byproducts (551) 15. Haloacetic: Acids (552) :16. Other Pesticides (SM-18/6630) 17: PetroleumHydrocarbon Scan (310-13) ORGANIC NONPOTĄBLE/SOLID ANALYSES 1. Purgeable Halocarbons (624)8260). * 2.. Purgeable Arömatics (624/8260) 3. Acrolein & Acrylonitrile (624) 4._Phthalàtes (606/8060) 5. Organöchiorine: Pesticides. (608/808Ö), ."PCB's (Aröchiors) (608/8080) 7: Herbicides (SM-18/6640, 8151); 8: Other.Pesticides (SM-18/6630). 9. Pètroteum Hydrocarbon Scan (310-13)' 11. Acid Extractablès (625)8270)* 12 Base Neutral Extractables (625/8270) 3)GC/MS Unknown Scan, 14. Purgeable Hàlocarbons (DEF)* 15: Purgeable Aromätics (DEF) 16: Pésțicides (DĘF)I •17. PCB's (Arochlors) (DEF) 1217 KINORGANIC ANALYSES REQUESTED,-Lab#:_ =riipi. (circle tests) 20. Acidity: 39. Aluminum Turbidit ,21. Alkalinity, as CaCO3: (40 Antimony 22 Bromide 41. Arsenic Conductivity, 5 Corrosivity (temp 6. BOD, (5 day) :7 Soluble BOD (5,day) Carbonaçeous BOD (5 day) 9 Chemical Oxygen Demand 10. Dissolved Oxygen: 11. Total Organic Carbon! 12: Total Organic Halides; Solids, Percent (%); Söliďš: Sëftleablễ ¿Solids. Suspended: •16!Solids; Total! *17! Solids, Total Dissolved)r ₺18) Solids: Toral Volatile) Mö Otherjad Sngl.1 sinh; NYC-WTC_000072229 +23~BromateLChlorate/Chlorite 42 Barium 24. Chloride 43.-Beryllium 25. Cyanide 44: Boron. : 26. Fluoride 45. Cadmium 27.Hardness, Total as CaCO3: 46- Calcium, as CaCO3 : 28.:Nitrogen: Ammonia as N. Calcium Ca+? 29 Nitiogen, Nitrate as N 48. Chromium, Total 30' Nitrogen, Nitrite as N. 31. Nitrogen, Totäl Kjeldähtas N; 59 Coantym: Hoxavalent 32.Oil and Grease: 51! Copper: 33 Phenol' 52Hron 34! Phosphorus. Total as:P 53!Lead! 354Phosphorus, Orthö asiP: 54>Magnesium: 36: Sulfates: 155. Manganese' 37! Surtäctants) 56: Mercuryt: 38rLIV254} ‚57, Mölybdenum: 58*Nickelz mexaso :Potassium 60. Seleniùr 61÷Șilvert 62. Sodium. 63. Fhalijur 64,/Vanadium, .65.Zinc : CLP, [66.Metals/CN: ¿67. Volatiles 68. Semi volatiles 69x Pesticides/PCBs) 17O: Disk Delivorablos TCLP* 71. TCLP:Metals) (72} TCLP-Pesticides) 17,3: TCLP-Herbicides, 74 LCL2:olatiless. 75:TCLP-BNA'S) steneon

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NYC-WTC_000072229Source: NYC Law Department, mirrored locally

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NYC-WTC_000071022 · Box DEP Box 61

Form documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.

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