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Chain of custody record for environmental sample testing

Machine-extracted title · confidence 90%

Form documenting the custody chain for samples sent to the Westchester County Department of Labs and Research.

NYC-WTC_000072973–000072977

Folder label: “AE 01940

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Scanned page image, NYC-WTC_000072974
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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: Sample Type (circle one): 1. Potable 3. Non Potable Treated 2. Non Potable 4. Other Time/Date Collected: 25.02 0805 Collected By: D. Scon Agency Code: Collected From: Location's/Individual's Name NYC DEP Street_ 10 He LAKE LLIVC City/St/Zip WLHACLA NY 110545 Identification of Source Collection Point CAT LEFF nelc: NYS-ELAP No. 10108 Form A-70 (rev.10/01) K9991,K9993, K9992 Botle +s P370, P0065, 42398, Q2299, C1417 Chain of Custody? No Comments: PWS #: _ Source ID: _Type Descriptor: Bill to: Name/Company Street City/StZip Phone#:_ Fax#: CA,CH, BI? 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 Othery Refrigerated?_ - yes _ no Chlorinated:? _ yes_ no Free Chlorine Res: _mg/L Total Chlorine Res: mg/L рH ORGANIC POTABLE ANALYSIS Trihalomethanes (524) XVolatile 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 MIBE 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) X GC/MS Unknown Scan - Phthalates (606MS) Other: RADIOCHEMICAL ANALYSIS Radon Other INORGANIC ANALYSIS REQUESTED - Lab#: - Color Turbidity рH Conductivity Corrosivity (temp: 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 XOther: - Acidity Alkalinity Bromide Bromate/Chlorate/Chlorite _°C) 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 X Antimony Arsenic Barium X Beryllium _ Boron Cadmium _Calcium, as CaCO3 Calcium, Ca+2 _Chromium, Total Chromium, Hexavalent X Cobalt Copper X Iron Lead Magnesium 2Manganese Mercury X Molybdenum _Nickel L0 Potassium Selenium Silver Sodium Z Thallium Vanadium Zinc CLP Metals/CN Volatiles Semi-violatiles Pesticides/PCB's ICLP TCLP-Metals TCLP-Pesticides TOLP-Herbicides TCLP-Volatiles TCLP-BNAs NYC-WTC_000072974

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NYC-WTC_000072974Source: NYC Law Department, mirrored locally

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Chain of custody record, Jan 2002 · Box DEP Box 62

NYC-WTC_000073075

Form documenting the custody chain for environmental samples submitted to the Westchester County Department of Labs.

12 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.994

machine-extracted · confidence unavailable · Check page ↗
Chain of custody record, Jan 2002 · Box DEP Box 62

NYC-WTC_000073056

Form documenting the custody chain for environmental samples submitted to the Westchester County Department of Labs.

11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.989

machine-extracted · confidence unavailable · Check page ↗

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