Chain of custody record, Westchester County Department of Labs

NYC 9/11 Public Portal Document

- ENVrRdNMENTAL SERVICES S'AMeCEXUBMjSSib'N'FOR / / '•OvSm WESTCHESTER’cdUNTY LABOhATORlEd AND RESEARCH - ’ ■ •• 2 Dana Road, Valhalla, New York 10595 ■ (914)593-5575 1 ■ NYS-ELAP No. 10108 ' . i/Date Set: Form A-70 (rev.1/96) .

Sam (circle one): "^1. Potable^.,,^ ;3. Non Potable Treated Bottle #’s: 7^ (^5^, QFG 2. Non Potable 4. Other___________ _ Chain of Custody?yes no ’ 7 Time/Date Collected: icri/j - '( Comments: ,4 Collected By: Agency Code: PWS #:_____ Source ID: • Type Descriptor: Collected From: Bill to: Location’s/lndividual’s Name OeP Name/Company street // ' Street_________ City/St/Zip City/St/Zip Identification of Source Phone#:_______ Fax#: Collection Point "p) I fi CA.CH, Bl? • ■ Check#: Amounts.

BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#: ___________________ Lab#:________________________ (circle tests) (circle tests) 1. Heterotrophic Plate l.’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) <3/ Volatile Aromatics (524) .... 3. Acrolein & Acrylonitrile (624). 3) Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential '(510) 4. Phthalates (625/8270) 'I, 4y Fecal Coliform (all samples) 5. Microextractables (504) 5. Orga'nochlorine Pesticides (608/8081) ’ 5,^icroscopic 6. Pesticides (507) ; 6. PCB’s (Arochlors) (608/8081)' ^^Bcroscopic ■’ 7. Methoprene‘(616) f’esticides/PCB.screeh,(508) , S.’^PCB as Decachlorobiphenyl (508A) ’ ?= '8., Herbicides jEPAI 978/8151) 8^ Other: -■ ___________ 9."Herbicides (515). ’ 9.. Pesticides..(SM18/6630) yes no Pesticides (525) , 10. Petroleum Hydrocarbon Scan (310-13) . ■ Refrigerated? '11.. Carbamate Pesticides. (531) ■ 11. Glycols . . Chlorinated:? yes no 12. Glyphosate (547) ; 1Z Acid Extractables (625/8270) 13. Diquat (549) 13. Base Neutral Extractables (625/8270) Free Chlorine Res:. mg/L 14. Chlorination Disinfection Byproducts (551). ^^GC/MS Semivolatile Unknown Scan Total Chlorine Res: mg/L 15. Haloacetic Acids (552) ’ 15. Purgeable Halocarboris (DEF) 16. Pesticides (SMI 8/6630) 16. Purgeable Aromatics (DEF) pH _L_____ 17. Petroleum/Hydrocarbon Scan (310-13) '17..Pesticides/PCB’s (DEF) 18. Other:^, 18. Other:

INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 1. Color 20. Acidity -. 3! Aluminum 59. Potassium . 2. Turbidity 21. Alkalinity,'as CaCOs <3£Antimony '• 60. Selenium 3. pH 22. Bromide 41. Arsenic 61. Silver 4. Conductivity 23. Bromate/Chloralte/Chlorite / 42-Barium < 62. Sodium 5. Corrosivity (temp:’C) 24. Chloride Jeryllium. ■ <3S^^hallium 6. BOD (5 day) 25. Cyanide. ... 44. Boron ■ rS^^anadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium?'■* b5?^Zinc 8. Carbonaceous BOD), (5 day) 27. Hardness, Total as CaCOs 46. Calcium, as CaCOs CLP 9,’ Chemical Oxygen Demand 28. Nitrogen, Ammonia as N . 47. Calcium,’Ca*2-' 66. Metals/CN '10., Dissolved Oxygen 29. Nitrogen, Nitrate as N -- 4'8.,Chrorhium; Total 67. Vofatiles 11. Total Organic Carbon) 30. Nitrogen, Nitrite,as W , , 4gjChronnium,Hexavalent. 68. Semi-violatiles -12?total,Organic.Halide^s^ 31/Nitrbgen’, Total Kjeldahl as N'O^^O^obaJt; ,69. Pesticides/PCB's , Solids,' Percent ’'(%); ’ 32. Oil an Grease). ‘ ' ■ '51: Copper’ 7O.'DisKD_eliverabies, ^^Soiids, Settleable .33. .PHenql. , . ;52?Jrqn? TCLP j: Solids; SuspendedJ 3X?Phosphorus.Tot'dl S^Lead. 35;.RtTOsph’6rui 6rtKo*as',F?> , 54. Magnesium . 7.1'TCLP-Metals 36iSu'lfat^y, ’ ’ . »-S5>enganese’ .72. TCLP,-Pesticide's' ■, IJ/.Sbiids? Total'Dissolved 37ASurfactants'/ ^^^Mercury)'^ .. 73/rCL5-Herbicides> “ ^?Solids:T^.\?^atile‘ j74:TfpLP.Volatiles! ^^^’Otlier:- (', ■ 38yuVS4<’ ■ ’ ^5^o^b^um1 ^75>-tCLl=-BN§'s: \ . 2W^NicfefC ■ •i.

NYC-WTC_000072269