Chain of custody record, Westchester County Labs, Oct 2001

NYC 9/11 Public Portal Document

.csiciKsif, ■ 2 Dans Road, VeMla, New York 10595 (9'14)593-55'75 fX AYO Time/Date Set;

/I. Potable,,.) 3. Non Potable Treated Bottle #’s: . 2. N(.n rok.iii,. -1 Othc Chain -Y Custody'? yr- no i . Comments: .................... FovKX.. - ■ r » r. , ™.,o r Type Descriptor: Collected By; Agency Code: PWS #:....... ... ... r»ID; .j Source - ----------------------------------- IBilailOlllilliiBIII Collected From: Bill to; Location’s/lndividual’s Name. 11 M Y ) ; •• Name/Company Street_____ ■___ ±.___.. - c ' V Siree: City/St/Zip ,c.......L-ll/ll . /> > Ki * C -Y * f'? City/St/Zip identification of Source__________________________ _ Phone#;„ Fax#: Collection Point Cfc.Cfc!'! 'W CA.CH, Bl?i Check#: Amounts

BACTERIOLOGICAL ANALYSIS ORGANIC POTABlx ANALYSIS organic: NONPOTABLFJSOI.ID ANALYSIS "Lab#:______ _____ _ ________ Lab#:_________ (circle tests) 1. Heterotrophic Plate 1. Trihalomethanes (524) ■■■ 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) .■2?; Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, ,stp) 'j/Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) ■ 3. Ar.5k.inB Aciyloniiiiie (624) 4. Phthalates (625/8270)’ 4. Fecal Coliform (ail samples) 5. Microextractables (504) 5. Orqanochlonne Pesticide; :608/8081) 6. PCB’s (Arochlors) (608/8 1) ■ .Msctoscopic ' M- i.r urnnc. (t U j •sSPCBasDecachlorobiphenv! (508A) t 8. Other: _ Pesticides (SMI 8/6630) 10. Petroleum Hydrocarbon Scan (310-13) RChgeteWh yes no Ch,oti„eted:7:Zyes„o rt Ca,ba„.a,e Pesticides (53,) ,2. Glyphosate (547) !toSohX ’Disi„,eo,l„„Byptoducts(5l ....... ............ ....... ........................................... ' FteeChiohoeResi Total ChlQilne Res: iTig/L 15. Haloacetic Acids (552) 15. Purgeabie Halocarbons (DEF) 16. Pesticides (SMI8/6630) 16. Purgeabie Aromatics (DEF) 17. Petroleum/Hydrocarbon Scan (310-13) 17, Pesticides/PCB's (DEF) Y 18. Other, 18. Other:----------------------------- -------------- ;r

INORGANIC ANALYSIS REQUESTED - Lab#: „;■) . £,4 i [ j . (circle tests) ' . . f -j 4 ! i( t-b Potassium 1. Color 20. Acidity ’ ^.Aluminum 4 ■ 2. Turbidity 21. Alkalinity, as CaCO?, / 40. Antimony 3. pH 22. Bromide ”41. Arsenic Mhh Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium Coriium 5. Corrosivity (temp:_.... _„.?C) 24. Chloride C^lBerylhum . ....... . H 6. BOD(5dav) 25. Cyanide 44, Boron '64. ■Vanadiui 7. Soluble BOD (5 day) - 26. Fluoride 45.Cadmium. Zinc- 8. Carbonaceous 9. Chemical BOD (5 Oxygen eLn/^ day) Hardness, Total 27, Nitrogerr, 28. Ammonia CaCOa as as N 46, Calcium, as ^Oalcium, Ca-CaCOs 28. Nitrogen. Ammonia as N Ivlalh/Cl 10. Dissolved Oxygen !!-““-■“’ 29. Nitrogen, Nitrate -Nirmg,.: .<■■ ................. Y:.:. , N .................... ..... ■ ■ as N 48. Chromium, iota! , . .......... Ie I olatiles i-violatiies icide^PCBS Ii ;;Ktsa.'“ So dis, Suspended 32. Oil an Grease 33 Phenol 70 Disk Di TCLP o5 D 71 YCLP-! ietals^ SoliOi 35. Phosphorus, Ortho as P 36. Sulfates 72. TCLP-! Solid! 73.1 Ci PS Solid! :t/. . I - i8. 5a. Nh /ni

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