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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_000072423
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NYC 9/11 Public Portal Document Westchester govcon ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 e/Date Set: Sample Type (circle one): 1Potable 3. Non Potable Treated 2. Non Potable 4. Other Time/Date Collected: 0920 10-16-01 Collected By: _ M.NEWMAN Agency Code: Collected From: Locations/Individuats Name NYCDEP / KENSICO 19VALTLK: DRIVE City/St/Zip VALHALLA, N4 10095 Identification of Source Collection Point CRO GH/ NYS-ELAP No. 10108 Form A-70 (rev.1/96 ф:8i94a18,7 21569:50 Bottle #'s: Chain of Custody? yes •no Comments: PWS #:_ Source ID: Type Descriptor: Bill to: Name/Company Street City/St/Zip Phone#: Fax#: 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 Macroscopic 8. Other: Refrigerated? Chlorinated:? Free Chlorine Res: yes uyes no Total Chlorine Res: mg/L _mg/L pH LabE (circle tests) 1. Trihalomethanes (524) 2. Volatile Halocarbons (524) VolatileAromatics (524) 4. Total Trihalomethane Potential (510) Microextractables (504) Pesticides (507) Pesticides/PCB screen (508) 9. PCB as Decachlorobiphenyl (508A) 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: INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) 1. Color 20. Acidity 2. Turbidity 21. Alkalinity, as CaCO3 3. рH 22. Bromide 4. Conductivity 23. Bromate/Chlorate/Chlorite 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 Solids, Settleable 33. Phenol Solids, Suspended 34. Phosphorus Total as P 16. Solids, Total 35. Phosphorus, Ortho as P 17. Solids, Total Dissolved 36. Sulfates 18. Solids, Total Volatile 37. Surfactants 19 Other: Sn, 38. UV254 25377 39, Aluminum 40. Antimony 41. Arsenic 42, Barium 43/Beryllium *44. Boron 45. Cadmium 46. Calcium, as CaCOs 47. Calcium, Ca* 48. Chromium, Total 49. Chromium, Hexavalent 50,Cobalt 51.Copper 52. Iron 53.Lead 54 Magnesium 55 Manganese 56. Mercury 5x Molybdenum 58. Nickel 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: moblo 59. Potassium BY 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. TCLP-Pesticides 73. TCLP-Herbicides 74. TCLP-Volatiles 75. TCLPBNA'S NYC-WTC_000072423

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NYC-WTC_000072423Source: NYC Law Department, mirrored locally

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