Chain of custody record, Westchester County Labs, Oct 2001

NYC 9/11 Public Portal Document Westchester gov.com ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914)231-1620 Fax (914) 231-1772 Time/Date Set: nelac NYS-ELAP No. 10108 Form A-70 (rev.10/01) Sample Type (circle one): ()Potable 3. Non Potable Treated 2. Non Potable 4. Other Time/Date Collected: 1-24-02 Collected By: L Wagner Agency Code: Collected From: Location's/Individual's Name_ N1C DFP Streetsa Wosllake Drive City/St/Zip . Velhalla NV 110593 Identification of Source Collection Point Cat Leff P•293 P• 341 @185 0-2414 Bottle #'s: C-1419 K 99ES v 4286 4 9987 Chain of Custody? Yes No Comments: PWS #: — Source ID: Type Descriptor: Bill to: Name/Company Street City/St/Zip Phone#: Fax#: CA,CH, BI? Check#: Amount$ BACTERIOLOGICAL ANALYSIS Lab#:_ Heterotrophic Plate Count (hemodialysis & all others) Coliform P/A (Public supplies) Coliform MPN (priv well, raw, stp) Fecal Coliform (all samples) Microscopic Macroscopic API Other: Lab#: Refrigerated? _ _yes - no Chlorinated:? yes_ no Free Chlorine Res:_ Amg/L Total Chlorine Res: mg/L pH RADIOCHEMICAL ANALYSIS Radon Other ORGANIC POTABLE ANALYSIS Trihalomethanes (524) Volatile Halocarbons (524) Volatile Aromatics (524) Total Trihalomethane Potential (510) Microextractables (504) Pesticides/PCB screen (508) PCB as Decachlorobiphenyl (508A) Herbicides (515) Pesticides (525) Carbamate Pesticides (531) Glyphosate (547) Diquat (549) Chlorination Disinfection Byproducts (551) Haloacetic Acids(552) Other Pesticides (SM18/6630) UCMR List 1 MtBE Only (524) ORGANIC NONPOTABLE/SOLID ANALYSIS Purgeable Halocarbons (624/8260) Purgeable Aromatics (624/8260) Acrolein & Acrylonitrile (8260) Organochlorine Pesticides (608/8081) PCB's (Arochlors) (608/8081) Herbicides (SM18/6630,8151) Other Pesticides (SM18/6630) Petroleum Hydrocarbon Scan (310-13) Glycols in Water Acid Extractables (625/8270) Base Neutral Extractables (625/8270) V GC/MS Unknown Scan Phthalates (606MS) Other: INORGANIC ANALYSIS REQUESTED - Lab#: Color Turbidity pH Conductivity Corrosivity (temp: _°C) BOD (5 day) Carbonaceous BOD (5 day) -/ Soluble BOD (5 day) Chemical Oxygen Demand Dissolved Oxygen Total Organic Carbon Total Organic Halides Solids, Percent (%) Solids, Settleable Solids, Suspended Solids, Total Solids, Total Dissolved Solids, Total Volatile Z Other: Acidity Alkalinity Bromide Bromate/Chlorate/Chlorite Chloride Cyanide Fluoride Hardness, Total as CaCO3 Nitrogen, Ammonia as N Nitrogen, Nitrate as N Nitrogen, Nitrite as N Nitrogen, Total Kjeldahl as N Oiland Grease Phenol Phosphorus Total as P Phosphorus, Ortho as P Sulfates Surfactants UV254 36 _ Aluminum Antimony Arsenic Barium Beryllium Boron Cadmium Calcium, as CaCOs Calcium, Ca+2 Chromium, Total Chromium, Hexavalent Cobalt Copper Vlron Lead Magnesium Z Manganese Mercury Molybdenum Nickel Potassium Selenium Silver sodiun Thalliur Vanadium Zinc CLP Metals/CN Volatiles Semi-violatiles Pesticides/PCB's TCLP TCLP-Metals TCLP-Pesticides TCLP-Herbicides TCLP-Volatiles TCLP-BNAS NYC-WTC_000072955