NYC Law Department release
Independent mirror · updated as the City releases more · v1.2.6
← Document results/DEP Box 61/25259
Document / 8 pages

Chain of custody form, Westchester County Labs

Machine-extracted title · confidence 90%

Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000072362–000072369

Folder label: “25259

Page image
Scanned page image, NYC-WTC_000072369
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM DU ■ster WESTCHESTER COUNTY LABORATORIES AND RESEARCH )v.com 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 /Date Set: 3 (onn A-70 (rev.1/96) ---------- —- )■/

Sample Type (circle one): ^^otable 3. Non Potable Treated Bottle J. /1 A\

2. Non Potable '4. Other____________ Chain of Custody?___ yes _2_ ho / <• Time/Date Collected: Comments: Collected By: Agency Code; PWS #:______ Source ID: .Type Descriptor: Collected From: Bill to: Location’s/lndividual's Name < ’J Name/Company Street_________________ Street_______ ' City/St/Zip______________ City/St/Zip Identification of Source Phone#: Fax#: Collection Point ) 7V CA.CH, Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#;_______________________ Lab#;________________________ (circle tests) (circle tests) 1. Heterotrophic Plate 1..^ Trihalomethanes (524) 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) Z2.'Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw, stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (625/8270) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) 5. Microscopic Pesticides (507) 6. PCB’s (Arochlors) (608/8081) ^^acroscopic 7. / Pesticides/PCB screen (508) 7. Methoprene (616) WRpi ”8. PCB as Decachlorobiphenyl (508A) 8. Herbicides (EPAI 978/8151) 8. Other;_____________________ 9, Herbicides (515) 9. Pesticides (SM18/6630) Pesticides (525) 10. Petroleum Hydrocarbon Scan (310-13) Refrigerated? yes no 11. Carbamate Pesticides (531) 11. Glycols Chlorinated:? yes___ no 12. Glyphosate (547) 12. Acid Extractables (625/8270) 13. Diquat (549) Base Neutral Extractables (625/8270) Free Chlorine Res:. _______ mg/L 14. Chlorination Disinfection Byproducts (551) ( 14/GC/MS Semivolatile Unknown Scan Total Chlorine Res:'.__ __ - 15. Haloacetic Acids (552) 15. Purgeable Halocarbons (DEF) mg/L 16. Pesticides (SM18/6630) 16. Purgeable Aromatics (DEF) pH 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pesticides/PCB’s (DEF) 18. Other;__________________ % 4 18. Other__________________________

INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 1. Color 20. Aridity 7^^ 39. Aluminum V 59. Potassium 2. Turbidity 21. Alkalinity, as CaCOs 40. Antimony 60. Selenium 3. pH 22. Bromide . 61. Silver t 4. Conductivity 23. Broniate/Chlorate/fenlpn^ 42. Barium 62. Sodium ! 5. Corrosivity (temp: 5C) 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 CaCOs 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-vioiatiles 12.-'Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt- 69. Pesticides/PCB’s . 1^3. Solids, Percent (%) 32. Oil an Grease Si. 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_000072369

OCR can misread numbers and units. Confirm readings against the page image before using them.

NYC-WTC_000072369Source: NYC Law Department, mirrored locally

Related records

Browse subjects →

Ranked by indexed similarity. Reasons describe shared subjects and filing context; check the source records.

Same-box records

Filed elsewhere

More like this page

Similar subjects in other documents. Similarity does not establish the same event, measurement or conclusion.

Page similarity is temporarily unavailable or this page has no indexed vector.

Others also read

Readers open these alongside this record — through an Ask answer, the same folder, or indexed similarity. Not a claim they are about the same event.

NYC-WTC_000071265 · Box DEP Box 61

Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research.

Similar indexed content

Compare copies and versions →