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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_000073060
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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: nelc NYS-ELAP No. 10108 Form A-70 (rev.10/01) Sample Type (circle one): A. Potable 3. Non Potable Treated 2. Non Potable 4. Other Time/Date Collected: 550 Collected By: D.aai011 1-21-cс . Agency Code: _ Collected From: Location's/Individual's Name A/~C De P Street11 TCORSTLAKE DI2NC City/St/Lip veeleilla l Identification of Source Collection Point_ Ca (GIP 4rla kini Bottle #s: 12591,0021 42229.2145 Chain of Custody? Yes No Comments: PWS #: - Source ID: Bill to: Name/Company Street City/St/Zip Phone#: _ Fax#: Type Descriptor: 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 Chlorinated:7 Free Chlorine Res: Total Chlorine Res: _ yes - no mg/L mg/L pH ORGANIC POTABLE ANALYSIS Trihalomethanes (524) Volatile Halocarbons (524) /Volatile Aromatics (524) Total Trihalomethane Potential (510) Microextractables (504) Pesticides/PCB screen (508) PCB as Decachlorobipheny (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 AcidExtractables (625/8270) Base Neutral Extractables (625/8270) GC/MS Unknown Scan Phthalates (606MS) Other:_ RADIOCHEMICAL ANALYSIS Radon Other INORGANIC ANALYSIS REQUESTED - Lab#: _ Color Turbidity рH 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 ae 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 LAntimony _Arsenic Barium kBeryllium Boron Cadmium Calcium, as CaCO3 _Calcium, Ca+2 _Chromium,Total Chromium, Hexavalent Cobalt Copper fron Lead *Magnesium _Manganese _Mercury y Molybdenum Nickel Potassium Selenium Silver Sodium LLThallium Vanadium Zinc CLP Metals/CN Volatiles Semi-violatiles Pesticides/PCB'S TCLP TCLP-Metals TGLP-Pesticides TCLP-Herbicides TOLP-Volatiles TCLP-BNAS NYC-WTC_000073060

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NYC-WTC_000073060Source: 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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