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Chain of custody record for Westchester County samples

Machine-extracted title · confidence 98%

Form recording the chain of custody for samples analyzed by Westchester County Department of Labs and Research.

NYC-WTC_000072420–000072423

Folder label: “25375

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Scanned page image, NYC-WTC_000072421
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OCR status: ocr · source: ours

NYC 9/11 Public Portal Document AWestchester pov.com ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 e/Date Set: NYS-ELAP No. 10108 Form A-70 (rev.1/96, Sample Type (circle one): 1. Potable 3. Non Potable Treated 2, Non Potable 4. Other Time/Date Collected: 945 10/16/01 Collected BytMilC.0 Agency Code: Collected From: Location's/Individual's Name DEP Street 14 wer (Aié Dr. City/St/Zip Valkallu Mg/0595 Identification of Source Collection Point (AT (1C C-0274 K-8185,6493,8187 •Botle 757,9123,9119 P•157.1192 Chain of Custody? - yes _ по Comments: PWS#: Source ID: Bill to: Name/Company Street City/St/Zip Phone#: _ Fax#: no k Type Descriptor: CA,CH, ВІ? Check#: Amount$ BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#: (circle tests) 1. Heterotrophic Plate Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 4. Fecal Coliform (all samples) 5. Microscopic acroscopic 8. Other: Retrigerated? Chlorinated:? _ yes no Free Chlorine Res: Total Chlorine Res: yes _ no _ mg/L _mg/L рH Lab#: (circle tests) 1.Trihalomethanes(524) 2. Volatile Halocarbons (524) 3 Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) 5. Microextractables (504) 6. Pesticides (507) Pesticides/PCB screen (508) 8. PCB as Decachlorobiphenyl (508A) 9. Herbicides (515) Pesticides (525) Carbamate Pesticides (531) 12. Glyphosate (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: 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) 11. Glycols 12. Acid Extractables (625/8270) 13. Base Neutral Extractables, (625/8270) GC/MS Semivolatile Unknown Scan 15. Purgeable Halocarbons (DEF) 16. Purgeable Aromatics (DEF) 17. Pesticides/PCB's (DEF) 18. Other: INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 375 Metals 1. Color 20. Acidity 39. Aluminum 2. Turbidity 21. Alkalinity, as CaCO3 40, Antimony 3. рH 22. Bromide 41. Arsenic 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 5. Corrosivity (temp: °C) 24. Chloride 43 Beryllium 6. BOD (5 day) 25. Cyanide 44. Boron 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 46. Calcium, as CaCO3 /9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca+2 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N 48. Chromium, Total 11., Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromium, Hexavalent 12: Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50, Cobalt 13. Solids, Percent (%) 32. Oil an Grease 51.Copper Solids, Settleable 33. Phenol 52. Iron Solids, Suspended 34. Phosphorus Total as P 53.Lead 16. Solids, Total 35. Phosphorus, Ortho as P 54 Magnesium 17. Solids, Total Dissolved 36. Sulfates 55 Manganese 18. Solids, Total Volatile. 37. Surtactants 56. Mercury 19. Other: 38. UV254 57 Molybdenum* 58. Nickel 59. Potassium 60. Selenium 61. Silver 62. Sodium 63, Thallium 64 Vanadium 65. Zinc CLP 66. Metals/CN 67. Volatiles 68. Semi-violatiles 69. Pesticides/PCB's 70. Disk Deliverables TCLP 71 .TCLP-Metals 72.1CEP-Pesticides 73. TCLP-Herbicides 74. TCLP-Volatiles 75. TCLP-BNA'S NYC-WTC_000072421

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NYC-WTC_000072421Source: NYC Law Department, mirrored locally

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