NYC 9/11 Public Portal Document
7 -Oi
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 . .................... - ......................... ..
Xhui a-:: Pi
■ - ! ■
!SP !
C
f
r ■ Si
•s. kUa D.oso:vod:
s. iota Vcintlie Vointiio
lii'i
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NYC-WTC_000073148
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