NYC 9/11 Public Portal Document
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1 New York 10595
.xESEARCH c/ j r.x V<»
(914)231-1620 Fax (914) 231-1772 *
NYS FLAP Nc. 10108
Time/Date Set; r -lH ! Form A-70 (rev. 10/01)
Sample Type (circle one):' ■ LV“ >33 '
f1>0table 3. Non Potable Treated Bottle #’s:
2. Non Potable 4. Other Chain of Custody?Yes No • i *-'<
Time/Date Collected: ■’ m i " - ■■ '
_______________________________
__ ___J Comments:
Collected By; .A:)'■; i'Drw r -■ Ai jcncy Code- ...... PWS#........... . Some.: ID:.. . Type Descript.!!:
Collected From: Bill to:
Location's/lndividual's Name j\.» ‘'v L A______ ; Name/Company:
Street i Street _ _____ _
City/St/Zip City/StfZip
Phone#: _ Fax#:
Collection Point ; ■ I 'i
CA.CH, Bi? Check#: Amounts
BACTERIOLOGICAL ANALYSIS Lab#::
Lab#: :
ORGANIC POTABL E. ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS
__ Heterotrophic Plate Count
__ T/ihalomethanes (524) __ Purgeable Halocarbons (624/8260)
(hemodialysis & al! others) ^X/Qlatile Halocarbons (524)
__ Coliform P/A (Public supplies)
.^Volatile Aromatics (524) =
__ Coliform MPN (priv well, raw, stp)
__ Fecal Coliform (all samples) — Total TrihalomethanerPotential
v. (510) (!:;t C'l les {WWVaOBi)
I (601
ZJS =S “
.......... cS’,
.................. les :sMi; 3/663(
estii •ide;/ 301
__other:______________ _
Refrigerated? yes„-no3
- Pesticides (525'
Carbamate Pesti
... /'Bn.vL,.. i s„,„
Chlorinated:?
Free Chlorine Res:
Total Chlorine Res:
J A'-
______ mg/L
______ mg/L
IIO
1
=SS?“ 7.,
Haloacetic Acids (552)
__ Other Pesticides (SM18/6630)
__ Other:________ ;____________ ___________'
) '
pH_____
RADIOCHEMICAL ANALYSIS ,..^MtBE Only (524) _ __
Radon
__ Other I
INORGANIC ANALYSIS REQUESTED - Lab#: BH
mill
__ Color __ Acidity __ Aluminum Potassium .. '
__ Turbidity ___Alkalinity _iXritimony . Selfinn.m
_ pH __ Bromide ___ Arsenic ........ Silver - :
__ Conductivity __ Bromate/Chlorate/Chlorite ___ Barium
__ Corrosivity (temp:“C) __ Chloride _><6eryllium
__ BOD (5 day) __ Cyanide ,___Boron _ Vanadium i..
l.'arboiiai’oous BOD iO dayi . . Fluoiidfc . . Ciidmiurii
. Solub!.’BOD (Sdny) __ Hardness, Total as CaCOs ___ Calcium, as CaCOs
Chemical Oxygen Demand^ __ Nitrogen, Ammonia as N: _ Calcium. Ca«' %,.a,s,CN
Dissolved Oxygen __ Nitrogen, Nitrate as N _Chromium. Total
v'nlaiiios
. ... Total Orgtinic Cuihoi. Nitrogen. Nitrilo ns N . Gitromium. Hexavalent «,ni.vWnlilori
ToiaiOipanic Halides
__ Solids, Percent (%) -• M.tr...... i.,, .i kioid-j.i ... m
-uSi... i
r-.u-.ii
■I •estid»loi./PCi
IB . . Solids, Settieable _ Phenol . :^ron
Cl
lO Sol d.;. Suspended Pitosphoni;. ’lokil ns P .. . Lend
1 - ixissssr Solids lotnl _... Phosphorus, Ortho ns P Muqtiesitim
ici
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NYC-WTC_000072887
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