Form documenting the transfer and receipt of samples at the Westchester County Department of Labs & Research.
NYC-WTC_000072313–000072315Folder label: “25072”
OCR status: ok · source: pdftotext
NYC 9/11 Public PortalDocument
ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM
111 ^KlchecterCourty WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914)593-5575 . . NYS-ELAP No. 10108 ^^e/Date Set:__________
Sample Type (circle one): jW 7 "7 ■" 7 Form A-70 (rev. 1/96)
I- I1* y-70 • , ^^otable 3. Non-Potable Treated BottldJf’s? •'/ ! 7 -.-5' ___________________ 2. Non-Potable 4. Other.____________________ Chain of Custody?yes no Time/Date Collected:. • Comments:> Collected By: < ; ■' O Agency Code: PWS #:________ Source ID: Type Descriptor:
Collected From. Bill to: Location’s/lndividual's Name. Name/Company. Street_____________________ Street_________ City/SVZip_________________ City/St/Zip Identification of Source____ Phone#:_ Fax #;. Collectiori Point I CA, CH, Bl?- Check#: Amounts
BACTERIOLOGICAL ANALYSES ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES 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) si/ Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8080) 5. Microscopic Pesticides (507) 6. PCB's (Arochlors) (608/8080) 6. Macroscopic Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) I^API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) irOther:______________________ Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) Pesticides (525) 10. Glycols in Water \Refrigerated? .yes. nd' 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) ^kBase Neutral Extractables (625/8270) . 13. Diquat (549) Q^GC/MS Unknown Scan Chlorinated?: yes. no 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) .^.■ Free'Chlorine Res;j rhg/L • 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) . r‘ ■ ' '' , 16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) Total.Chtorine Res: mo/ti 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB's (Arochlors) (DEF)
pH. _____________
INORGANIC ANALYSES REQUESTED - Lab#: (circle tests) 1. Color 20. Acidity 39. Aluminum 59. Potassium C-i 2. Turbidity ' 21. Alkalinity, as CaCOa 40. Antimony 60. Selenium 3.." pH 22. Bropide 41. Arsenic 61. Silver 4. Conductivity 23. Brbmate/Chlorate/Chlorite 42. Barium 62. Sodium 5. Corrosivity (temp: ."C) 24. Chloride 43. Beryllium 63. Thallium 6. BOD (5 day).. 25. Cyanide 44. Boron 64. Vanadium ' 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc____________ 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCOa 46. Calcium, as CaCOs CLP 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca*’ 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 Hafides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pesticides/PCB's Solids, Percent (%) 32. Oil and Grease 51.Copper 70. Disk Deliverables Solids. Settleable 33. Phenol 52. Iron TCLP 15. Solids. Suspended 34. Phosphorus. Total as P 53. Lead 71. TCLP-Metals 16. Solids. Total 35. Phosphorus, Ortho as P 54. Magnesium 72. TCLP-Pesticides 17. Solids. Total Dissolved 36. Sulfates 55. Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles 19. Other:_______________ 38. UV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel
NYC-WTC_000072315
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NYC-WTC_000071348
Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.994
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072760
Fragmented chain of custody record for samples submitted to Westchester County Department of Labs and Research.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.993
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072249
Form documenting the transfer and logging of environmental samples at the Westchester County laboratory.
8 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.993
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072684
Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.993
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000070981
Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research including contact information.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.993
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071466
Record documenting the transfer and chain of custody for samples sent to the Westchester County Department of Labs.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.993
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071184
Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research including contact information.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.992
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000070907
Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research including sampling contact information.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.992
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000071974
Document tracking the transfer and custody of samples received by Westchester County Department of Labs & Research.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.992
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000072362
Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.992
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000070896
Record detailing the chain of custody including specific sampling and analysis instructions for the Westchester County laboratory.
10 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.992
machine-extracted · confidence unavailable · Check page ↗NYC-WTC_000027531
Documentation tracking the transfer and handling of environmental samples between collection sites and the Westchester County Department of Labs.
10 shared non-person entities · 1 shared topics · similarity 0.993
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