Chain of custody record, Westchester County Labs, Oct 2001

NYC 9/11 Public Portal Document Westchester ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM gov.com WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 neac (914)231-1620 Fax (914)231-1772 NYS-ELAP No. 10108 Time/Date Set: Q- 2413 Q: Z41 Form A-70 (rev.10/01) Sample Type (circle one): P-2595 P-2596 (1. Potable 3. Non Potable Treated Bottle #'s: C-1414 k:9973 x 9974 K9975 2. Non Potable 4. Other Chain of Custody? Yes No Time/Date Collected: 1-24-02 Comments:- Collected By: L. Wagner Agency Code: PWS #: _ Source ID:_ Type Descriptor: Collected From: Bill to: Location's/Individual's Name NYC DFP Name/Company- Westlake briue Street City/St/Zip Volhallo Ny 10595 City/St/Zip Identification of Source Phone#: Fax#: Collection Point CRu Gil CA,CH, BІ? Check#: Amount$ 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 Other: Refrigerated? _ -yes . no Chlorinated:? yes no Free Chiorine Res:_ - mg/L Total Chlorine Res: _ рH 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:_ RADIOCHEMICAL ANALYSIS Radon Other INORGANIC ANALYSIS REQUESTED - Lab#: Color _ Acidity Turbidity Alkalinity pH Bromide Conductivity Bromate/Chlorate/Chlorite Corrosivity (temp:_ °C) Chloride BOD (5 day) Cyanide Carbonaceous BOD (5 day) Fluoride Soluble BOD (5 day) Hardness, Total as CaCO3 Chemical Oxygen Demand Nitrogen, Ammonia as N Dissolved Oxygen Nitrogen, Nitrate as N Total Organic Carbon Nitrogen, Nitrite as N Total Organic Halides Nitrogen, Total Kjeldahl as N Solids, Percent (%) Oil and Grease Solids, Settleable Phenol Solids, Suspended Phosphorus Total as P Solids, Total Phosphorus, Ortho as P Solids, Total Dissolved Sulfates Solids, Total Volatile Surtactants CZ Other: UV254 Aluminum ZAntimony Arsenic Barium Beryllium Boron Cadmium _ Calcium, as CaCO3 2 Calcium, Ca*2 _Chromium, Total Chromium, Hexavalent Cobalt Copper Iron ~Lead Magnesium L Manganese Mercury L Molybdenum Nickel Potassium Selenium -Silver Sodium Thallium Vanadium Zinc CLP Metals/GN Volatiles Semi-violatiles Pesticides/PCB's TGLP TCLP-Metals TCLP-Pesticides TCLP-Herbicides TCLP-Volatiles TCLP-BNA'S NYC-WTC_000072957