Chain of custody record, Jan 2002

NYC 9/11 Public Portal Document

- ,,, ENVIRONMENTAL SERVICES SAMPreSU3M,SSiONrO.M ' WESTCHESTER COUNTY LABORATORIES AND RESEARCH . 2 Dana Road, Valhalla, New York 10595 ' (914)231-1620 Fax (914) 231-1772 x NYS-ELAP No, 10108 Time/Date Set; f.’.. ?. /, '7, > Foiin A-70 (rov. 10/01)

Sample Type (circle one): 6> Hs d' ■2.’9-7 ^pPotable 3. Non Potable Treated Bottle __ Yes ■ No 9/00 2. Non Potable 4. Other____ ________________ ______ _ Chain of Custody? J Time/Date Collected: t:% / - foC? Comments: IIIBBIBIIIIIIIIOIliillilllllllBlIBIIIIil Collected By: L ■ Horp » Agency Code: Source ID:Type Descriptor: Collected From: Bit! to: Location's/lndividual’s Name N YC r» P __________ Name/Company• Street t 9 Si oUC 0 r > Yf______________

City/St/Zip City/St/Zip: Phone#:_________ Fax#;: Collection Point (2 cO Iff*-_________________________ _ CA,CH, Bl? Check#r Amount$

BACTERIOLOGICAL ANALYSiS Lab#:

ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS __ Heterotrophic Plate Count __ Purgeabie Halocarbons (624/8260) (hemodialysis & all others) u/Voiatile Halocarbons (524) __ Purgeabie Aromatics (624/8260) __ Coliform P/A (Public supplies) __ Coliform MPN (priv well, raw, stp) .iBVolatile Aromatics (524) __ Acrolein & Acrylonitrile (8260) , __ Fecal Coliform (ail samples) __ Total Trihalomethane Potential (510) __ Organochlorine Pesticides (608/8081) __ Microscopic __ Microextractables (504) __ PCB's (Arochlors) (608/8081) __ Macroscopic __ Pesticides/PCB screen (508) ___ Herbicides (SM18/6630,8151) __ PCB as Decachlorobiphenyl (508A) __ Other Pesticides (SM18/6630) _ API __ Other:1 j _ Herbicides (515) __ Petroleum Hydrocarbon Scan (310-13) __ Pesticides^ (525) __ Glycols in Water Refrigerated?yes no __ Carbamate Pesticides (531) Acid Extractables (625/8270) Chlorinated:?____ yes no __ Base Neutral Extractables (625/8270) . __ Diquat (549), , uxGC/MS Unknown Scan Free Chlorine Res:) - mg/L _ Chlorination Disinfection Byproducts (551) _ Phthalates (606MS) Total Chlorine Res: : - mg/L _ Haloacetic Acids (552) _ Other:... _Other Pesticides (SM18/6630): pH _____________ _ UCMR List 1 RADiOCHEMiCAL ANALYSiS ___ Radon

51 INORGANIC ANALYSIS REQUESTED - Lab#: __ Color __ Acidity _ _ Aluminum __ Potassium _ Turbidity __ Alkalinity _.igXntimony , Selenium pH __ Bromide Silver IO ___ Conductivity __ Bromate/Chlorate/Chlorite . . Sf.duim __ Corrosivity (temp:. .“C) __ Chloride j^'Thallium BOD (5 day) __ Cyanide __ Boron __ Vanadium __ Carbonaceous BOD (5 day) __ Fluoride __ Cadmium Zinc ___ Soluble BOD (5 day)* __ Hardness, Total as CaCOs __ Calcium, as CaCOa __ Chemical Oxygen Demand ___ Nitrogen, Ammonia as N __ Calcium, Ca+2 Dissolved Oxygon „„Metals/CN . Nitrogen, Nitrate as N __ Chromium, Total „Chromium. Hexavalen, . ... Volatiles 'gg,,:. . __ Total Organic Carbon __ Nitrogen, Nitrite as N __ Total Organic Halides __ Nitrogen, Total Kjeldahl as N j^obalt _ Solids, Percent (%) __ Oil and Grease ___ Copper ... ■■ Solids, Settleable ___ Pheno! _i^ron

7 as/ST'""' .... SOIMV Total Dissolved ..... Sulk.tos ...4lnim.mose .. IClP-Pestictdes . lWMk,rt«dd«R ... . Soliiis. iuiai voi.ihic Surf<«n.itil:. M.-nuiv .Xjlbur: -..--I.. UWM ’.XlM/tan TCLP.VJdUU..s

NYC-WTC_000073041