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Chain of Custody Record, Westchester County Dept of Labs

Machine-extracted title · confidence 90%

Document recording the custody chain and handling details for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000073316–000073332

Folder label: “AE 02710

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Scanned page image, NYC-WTC_000073327
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NYC 9/11 Public Portal Document WestchesterL pov.com ENVIRONMENIAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY, LABORATORIES AND RESEARCH: 2 Dong: 231: 0 Đig (99) 280 192 Time/Date Set: Sample Type (circle one): 1:Pötable 3. Non Potable Treated -2-Non Potable .4. Other Time/Date Collected: 215/02.1245 Collected By:i. Motea Agency Code: Collected Fröm: Location's/lndividrais Name Ma41 C. Street W'ApE City/SU/Zip _ Valhalla Identification of Source Collection Point (Ac G/: nelac 1NYS-ELAP Nö: 10108 Form A-7.0 (rev.10/01) wid norr 14:70,21 T HleT Q 64875547591 P.3T,g364 2303 Bottle #'s: Chain of Custody?!. -yes'_ _ NO. Comments: PWS#: - Source ID:: Type Descriptor: _.. Bill to: Name/Company Street City/St/Zip Phone#: Fax#: CA,CH, ВІ? - _ Check#: _ Amounts_ BACTERIOLOGICAL ANALYSIS Lab#: - Heterotrophic Plate Count (hemodialysis & all others) - Coliform P/A (Public supplies) ,Coliform MPN (priv well, raw, stp) _ Fécal'Coliform (all samples) — Microscopic - Macroscopic APL, _Other:_ Refrigerated? i _ yes1 no Chlorinated:?! _ yes Free Chlorine Res:. Total Chlorine Res: _mg/L . mg/L pH Lab#: ORGANIC POTABLE ANALYSIS Trihalomethanes (524) /Volatile Halocarbons (524) VVolatile Arómatics (524) _ Total Trihalomethane Potential (510) Microextractables, (504) Pesticides/PCB'screén (508). - PCB as Decachlörobiphenyl (508A) - Hèrbicides (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 NOŃPÖTÁBLE/SOLID ANALYŚIS: Pụrgęąble Hälocarbons…(6Ż4/8260) ‚ Purgeable 'Aromatics : (624/8260) «Acroléin & Acrylonitrile (8260); Organöchlorine Pesticides (608/8081) ' BCBS, (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) LGC/MS Unknown.Scan Phthalates (606MS); ;Othier: RADIOCHEMICAL ANALYSIS Radon Other 27i INORGANIC ANALYSIS REQUESTED - Lab#: - Colors Acidity Túrbidity Alkalinity Bromide Conductivity Bromate/Chlorate/Chlorite Corrosivity (temp: °C) Chloride BOD (5 day) Cyanide _ Carbonaceoüs BOD (5 day). Fluoride Soluble BOD (5 day): Chemica.Oxygen Demand... ='Hardness; Total as CaÇO5. Nitrogen; Ammonia as N; ÷ Dissolved Oxygen =:Nitrogen; Niträte as N - Total.Organic Carbon 'Nitrogen, Nitrite as N Total. Organic. Halides, Nitrogen: Tótal"Kjeldahlas NJ Solids; Percent! (%): Oil and,Grease Solids! Settleable: solids»Suspended, = Phenol) Phosphorus Total as e Solids Totali Phosphorus; Ortho, as P - Solids, Total Dissolved! Suifates Solids: Total Völatilề: Surfactants: Other»_ ÜV254: - Alüminum Antimony, "VArsenic &Barium y Beryllium --Boron Cadmium _Calcium; as ÇaCOş Calcium, Cat2 Chromium, Total Chromium; Hexavalent :i Cobalt) w Copper Aron! Lead: _ Magnesiums =Manganese" Mercury: L Mölybdénum! Nickeli a..c. Potassium .. ¿sëlenium ESiver® Sodium: thallium CLP." :żMètals/ÔN! Volatiles; Semi violatiles: « Pesticides/PCB's: ICLP -TCLP'Metals TCLP:Pesticides _ȚCLe-Herbicidess TCLP-Volatiles TCLP-BŇÄSR NYC-WTC_000073327

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