Chain of custody record, Westchester County Labs, Oct 2001

NYC 9/11 Public Portal Document Westchester gov.com Time/Date Set: Sample Type (circle one): 1Potable 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 NyC DEP Street 19 Westlake Deaue City/St/Zip Vaihola Ny 10595 Identification of Source Collection Point Del 18 ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 231-1620 Fax (914) 231-1772 nelac NYS-ELAP No. 10108 /PFB•316 P-474 P.0166 Form A-70 (rev.10/01) QFB-118) 0-1381 Q:2400 Bottle #'s: C-1415 KiB-0448, K-9988 Chain of Custody?.Yes No K 9989 K 9990 Comments: PWS #:_ Source ID: Type Descriptor: Bill to: Name/Company Street City/St/Zip Phone#: Fax#: CA,CH, BI? Check#: Amounts BACTERIOLOGICAL ANALYSIS Lab#: 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 Othera Refrigerated? - yes Chlorinated:? yes no Free Chlorine Res: Total Chlorine Res: _no mg/L Lmg/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) /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 _ 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 Oil and Grease Phenol Phosphorus Total as P Phosphorus, Ortho as P Sulfates Surfactants UV254 Aluminum Antimony Arsenic Barium 1Beryllium Boron Cadmium .Calcium, as CaCO3 Calcium, Ca+2 Chromium, Total Chromium, Hexavalent Cobalt Copper Lfron Lead Magnesium Manganese _ Mercury Molybdenum Nickel Potassium Selenium Silver Sodium LThallium Vanadium Zinc CLP Metals/CN Volatiles Semi-violatiles Pesticides/PCB's TCLP TCLP-Metals _TCLP-Pesticides TCLP-Herbicides TCLP-Volatiles TCLP-BNA'S NYC-WTC_000072956