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Chain of custody record, Westchester County Dept of Labs, Jan

Machine-extracted title · confidence 90%

Document recording sample chain of custody for the Westchester County Department of Labs and Research.

NYC-WTC_000073144–000073155

Folder label: “AE 02380

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Scanned page image, NYC-WTC_000073148
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NYC 9/11 Public Portal Document

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siB^wS^ 2 Dana Road, Valhalla, New York 10595 1 7914', 231-1020 Fax (914) 231-177? «lI..I?W ir

Timp/natP Spf NYS-rLAP No. 10103 Time,>Date Set. Form A-70 (rev. 10/01)

Sample Type 1. Potable "' V Non Potable Treated Bottle rs:__________ / M Z M __________

ZNcmPutahle 4 Other . i........ . ............... Chain n! Custody?....... Yen, .No Time/Date Collected:,:) / I 9 / 6 < a Comments: Collected By: Agency Code: □ZLzjL-' PWS #;Source ID: Type Descriptor: H Collected Frotn: BUS to; Location's/lndividual’s Name__ _____ ? Name/Companyi Street___ _____ ____ Street_________ City/St/Zip _ _________ City/St/Zip identification of Source Phone#: I Fax#; Collection Point I- iy - X •" CA.CH, Bl? j Check#: __ Amounts_______

BAG reRIOLOGICAL ANALYSIS .............................. ■ * ■BOI ........................... ......................................................................................................................................................................................................................................

Lab#;___________________________ OliGANiC POTABLE ANALYSIS ORGANIC NONPOTABLEZSOLID ANALYSIS Heterotrophic Plate Count (hemodialysis & ail others) _Trttalo™««e8 (524) „ Halocarbons (624/8260) __ Coliform P/A (Public supplies) __ Volatile Halocarbons (524) ___ Purgeabie Aromatics (624/8260) __ Coliform MPN (priv well, raw. stp) _ _ Fecal Coliform (all samples) Zr“XeS„rP:’,er.,« (5,0) Z . Microscopic _ Macroscopic Zp“X8S’(5O8) z ' i _ HCHns DccachinmhinhnnC il-fihA, Othn: Pnsiicidcs (SMIS.-Ondh) ' ’ ”” Othlr _ Hnihicfe (Sih) ig.rokiu,nlivdn. irhonS,.^ _ Pesticides (525) ~ Glycote In Water Refrigerated?yes no __ Carbamate Pesticides (531) . .. Acid Extractables (625/8270) ■ ': Chlorinated:? yes no __ Glyphosate (547) ..... Base Neutral Extractables (625/8270) . .Diguol(549) .AoC/MStinknownScnn nin.'L Fn-r f)hioiinc Res. ........ Total Chlorine Res:rng/L • ■ . tdiiorinntion Dis.nl,H.iion BviM-nliir.ls (551) I i.ikxKXitic Acids (;.y(>;>) .. Philvilnli's rudUMS! Pi.lh.A.U.siHXiMK) Other;i ,__Other Pesticides (SM18/6630) i pH......................... _UCMRList1 "''(^ADibcH^icAL'ANALYSi's' ___ Radon ■ ^■1 II " „ Other_________________________ ■ INORGANIC ANALYSIS REQUESTED - i .ih.z ............................. __ Color ___ Aridity _ Aluminum __ Potassium

zr* __ Conductivity z^ss __ Bromate/Chiorate/Chlorite Exssr ___ Barium ___ Sodium . »- Goimsivity (temp-.......... "C) .. . Gliloride . Horylliiim Thallium HGD(5day) Cyanulu . Ik.ron . Vinndium ZBZ,,cr„rC.Cc -gS™sCaCO, ---------- Z' -

Z gSSSZ’™"" - N™Sn:“sN " .. :ali-.'CN

z;s^?sss:x E3KRS&-H ES— . , . .-1 __ Voiatiies __Sem-violatiles

■ Solids, Settleable __ Pest cides/PCB’i I I St-jds. oiK-.i'cnaea ...........................................

Soiiis, Iola i . .................... - ......................... ..

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NYC-WTC_000073148Source: NYC Law Department, mirrored locally

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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 0.978

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