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Chain of custody record, Westchester County Department of Labs

Machine-extracted title · confidence 95%

Record tracking the chain of custody for environmental samples submitted to the Westchester County laboratory.

NYC-WTC_000072330–000072334

Folder label: “25154

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Scanned page image, NYC-WTC_000072332
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OCR status: ocr · source: ours

NYC 9/11 Public Portal Document Westchester gov.com ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 Time/Date Set: Sample Type (circle one): 1)Potable 3. Non Potable Treated 2. Non Potable 4. Other Time/Date Collected: 0830 10/17/01 Collected By:_ //1.NEWMAN Agency Code: Collected From: Location's/Individual's Name NYCDEP/KENSZCO Street 19WESTLK. DEIVE City/St/Zip VALHALLA, NY 10575 Identification of Source Collection Point CROG NYS-ELAP No. 10198 Form A-70 (rev.1/9 ST8:245,035,72051925 4Fb-*715:HE Bottle #'s: Chain of Custody?yes а по Comments: PWS #: Source ID:_ Type Descriptor: Bill to: Name/Company Street City/St/Zip Phone#:L Fax#: CA,CH, BI? Check#: Amount$_ BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#: (circle tests) 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Colitorm P/A (public supplies) 3. Colfform MPN (priv well, raw, stp) 4. Fecal Coliform (all samples) 5. Microscopic 6. Macroscopic 7. API 8. Other: Refrigerated? Chlorinated:? yes yes Free Chlorine Res: Total Chlorine Res: nO - пО mg/L mg/L pH INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 1. Color 20. Acidity 2. Turbidity 21. Alkalinity, as CaCO3 3. pH 22. Bromide 4. Conductivity 23. Bromate/Chlorate/Chiorte 5. Corrosivity (temp: °C) 24. Chloride 6. BOD (5 day) 25. Cyanide 7. Soluble BOD (5 day) 26. Fluoride 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 12: Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 13. Solids, Percent (%) 32. Oil an Grease 14. Solids, Settleable 33. Pnenol 15. Solids, Suspended 34. Phosphorus Total as P 16. Solids, Total 35. Phosphorus, Ortho as P 17. Solids, Total Dissolved 36. Sultates 18, Solids, Total Volatile 37. Surfactants 19. Other: 38. UV254 Lab#: (circle tests) Trihalomethanes (524) 2. Volatile Halocarbons (524) Volatile Aromatics (524) 4. Vlotal Trhalomethane Potential (510) Microextractables (504) 6. Pesticides (507) Pesticides/PCB screen (508) 8. PCB as Decachlorobiphenyl (508A) 9 Herbicides (515) Pesticides (525 11. Carbamate Pesticides (531) 12. Giyphosate (547) 13. Diquat (549) 14. Chlorination Disinfection Byproducts (551) 15. Haloacetic Acids (552) 16. Pesticides (SM18/6630) . 17. Petroleum/Hydrocarbon Scan (310-13) 18. Other: 25495 39 Aluminum .40, Antimony 41. Arsenic 42. Barium 43) Beryllium 44. B0ron 45. Cadmium 46. Calcium, as CaCO3 47.Calcium, Ca*2 48. Chromium, Total 49. Chromium, Hexavalent 1. Purgeable Halocarbons(624/8260) 2. Purgeable Aromatics (624/8260) 3. Acrolein & Acrylonitrile (624) 4. Phthalates (625/8270) 5. Organochlorine Pesticides (608/8081) 6. PCB's (Arochlors) (608/8081) 7. Methoprene (616) 8. Herbicides (EPA1978/8151) 9. Pesticides(SM18/6630) 10. Petroleum Hydrocarbon Scan (310-13) 12. Acid Extractables (625/8270) 13. Base Neutral Extractables (625/8270) (14) GC/MS Semivolatile Unknown Scan 15. Purgeable Halocarbons (DEF) 16. Purgeable Aromatics (DEF) 17. Pesticides/PCB's (DEF) 18. Other: 54 Magnesium 55 Manganese 56. Mercury 57 Molybdenum 58. Nickel S 59. Potassium 60. Selenium 61 Siver 62 Sodium 63. Thailium 64 Vanadium 65. ZInc CLP 66. Metals/CN 67Volatiles 68. Semi-violatiles 69. Pesticides/PCB's 70. Disk Deliverables TCLP 71.TCLP-Metals 72. TCLP-Pesticides 73, TCLP Herbicides 74.TCLP-Volatiles 75. TCLR BNAS NYC-WTC_000072332

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NYC-WTC_000072332Source: NYC Law Department, mirrored locally

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