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Chain of custody record, Jan 2002

Machine-extracted title · confidence 95%

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

NYC-WTC_000073056–000073060

Folder label: “AE 02088”

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Scanned page image, NYC-WTC_000073058
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OCR status: ocr · source: ours

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: Collected By: 12. MESICA E0O ЛИA _ Agency Code: Collected From: Location's/lndividual's Name AMC DeP Street M LUESTLAICEDENC City/St/Zip VeclhataASt -10TES Identification of Source Collection Point C206- 1-20-CC nelac NYS-ELAP No. 10108 Form A-70 (rev.10/01) С1383, К 9042 021127110 Bottle #'s: p 800,sor. 791,0227spF) 2427 Chain of Custody? Yes No Comments: Sandel 794 BKc 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: _ Refrigerated? yes no Chlorinated? yes_ no Free Chlorine Res:_ mg/L Total Chlorine Res: -mg/L pH Lab# ORGANIC POTABLE ANALYSIS Trihalomethanes (524) /Volatile Halocarbons (524) LVolatile 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: RADIOCHEMICAL ANALYSIS Radon Other INORGANIC ANALYSIS REQUESTED - Lab#: _ Color Turbidity pH Conductivity Corrosivity (temp:a °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 \ D:l) Aluminum LAntimony Arsenic Barium yBeryllium Boron _Cadmium Calcium, as CaCO3 Calcium, Ca+2 Chromium, Tota Chromium, Hexavalent →Cobalt Copper →/lron Lead - Magnesium Manganese Mercury Molybdenum Nickel Potassium Selenium Silver Sodium Thallium Vanadium Zinc CLP Metals/CN Volatiles Semi-violatiles Pesticides/PCB's TCLP LTCLP-Metals TCLP-Pesticides TCLP-Herbicides TCLP-Volatiles TCLP-BNA'S NYC-WTC_000073058

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NYC-WTC_000073058Source: 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.

11 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.991

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