Chain of Custody Record, Westchester County Dept of Labs

es NYC 9/11 Public Portal Document pee ee Mew ote ste woe ee ENVIRONMENTAL: SERVICES, SAMBLE:SUBMISSION’ FORM: AD os WESTCHESTER. ‘COUNTY, LABORATORIES S'AND- RESEARCH ; . Time/Date Set: : . 2 Dana Road, Valhalla; ‘New York - 10595. (914) 231- 1620 « Fax (914) 231- 1772 "8 BE NYS- ‘ECAP No'- 10108. ot __. Soluble’ ‘BOD (5 day) Hardness: Total’ as “CacOs nak _ Le. ‘ Form A-70 unis 10/01 yen Sample Type (circle orie): “p HW ; 6 Y iy . ’ 4. Potable . 3. Non Potable Treated. ¥ Bottle #'s! Zz " a ‘2. Non‘Potable- 4. Other- ap Chain of Custody?;__ Yes ___ te “Time/Date Collected: Bf zfs o 2. Comments: . a a " Collected By: Lab - Agony Code: A Ver We PWS. #: Source ID: Type Descriptor: Collected From: i f 6 L Bill to: ; _ Location’s/Individual’s Name is a AN Name/Company s Street — Street City/SUZip ~ EE City/St/Zip Identification of Source "2 Phone#: Fang: - — Collection Point f. a CACH, BI? ~ Check: ~ Amounis BACTERIOLOGICAL ANALYSIS Labi Zi “) 1.2 a a . Lab#: __. ff H hic Plate Count * orcanic PO ABLE ANALYSIS — ORGANIC NONPOTABLE/SOLID ANALYSis * — themedtabele & aflothers) “_Trihaloinethanes (524) __ Purgeable Halocarborig (624/8260)) «|= Coliform P/A (Public supplies) _— Volatile ‘Halocarbons (524) __ Purgeable Aromatics: (624/8260)' tt Coliform MPN (priv well, raw, stp) __ Volatile. Aromatics (524)’ _ Acrolein '& Acrylonitrile : (8260)... ~~ Fecal Coliform (all samples) ___ Total Trinalomethane Potential: (510) __.Organochlorine Pesticides: (608/868) ‘p: Te Microscopic ___ Microextractables (504) _—_;PCB's ‘(Arochlors) | (608/8081) . — ~~ Macroscopic _ Pebticidss/P CB" soreén "(608)> __ ‘Herbicides (SM18/6630, 8151); Pose ~~ API a “PCB. as. 'Decachlorobiphenyl, (508A) ___ Other Pesticides (SMi8/6630) ~~ Other: 2 Herbicides* (615) _.. Petroleum Hydrocarbofi Scan ee -13), — ° __ Pesticides’ (525)' _*Glycols’i in-Water . ‘| Refrigerated? ___ yes ___ no __‘Carbarnate Pesticides (531)' __ Abid ‘Extractables (62518270): * Hi Chlorinated:? yes __ Glyphosate (547)* Base Neutral Extractables: (625/8270)" | . j ~~ __Diquat : (549) GC/MS: ‘Unknown Scari* ia Free Chlorine Res: mg/L _— Chlorination Disinféction Byproducts (551); __ Phthalates (@06MS) roa } Total Chtorine Res: “mg/L __ Haidacetic Acids (552) ’ __' :Other:: : , pH __ Other Pesticides (SM18/6630) ae : = __UCMR List 1 * RADIOCHEMICAL ANALYSIS __ MtBE Only (524) - . - a — |__ Radon , “ - aor |__ Other — INORGANIC ANALYSIS REQUESTED - Lab#: to et __ Color “ ___ Acidity _ Aluminum ° . __ Potassium _.. Turbidity — Alkalinity _: Antimony ; __ Selenium’ _. pH __ Bromide — Arsenic — Silver, ° _— Conductivity _— Bromate/Chlorate/Chlorite __ Barium __ Sodium : _ ~ Corrosivity (temp: °C) ___ Chloride’ — Beryllium ° _ Thallium: . _:-BOD (5 day) ___ Cyanide _- Boron ‘ __. Vanadium _ Carbonaceous BOD: (5 day), __ Fluoride, __ Cadmium, __ Zinc, _-Calcium, as CaCOs: — __. Chemical ‘Oxygen Demand; =~ — Nitrogen, Ammonia'as.N* — Calgiuni;:Car? . ey AMetal ion __ Dissolved Oxygen, __ Nitrogen; Nitrate.as N __ Chromium, Total q ve ne _— Total Organic, Carbon __..Nitrogen: Nitrita’as,N” __. Chromium, Hexavalent; gm vik ti __.. Total. Organic Halides’ . __. Nitrogen, Total.Kjeldahl as N}. _.. Cobalt" Pestle si oe __. Solids, Percent (%) il and: ‘Grease, __ Copper; esticides: Ss, —_ Solids; Settleable; ‘ _~ Phenol, __ Iton: lercip __ Solids; Sipended __, Phosptiorus: Total/as: Pp — Lead; si TCLP:Métals. — Solids, Total __ Phosphorus:, Ortho « as.P- _ Magnesium: al = TCLP:Pesticides: ° __, Solids, Total Dissolved: __. Sulfatés = = Manganese ~ FCip Herbicides) __ Solids, Total Volatile” —. Surfactarits, = Meretry, = TELE Nolatios, = Site 1 — wv2e4; um: = “TCERBNAS 2 = Nickel i iiak diesen adie Si i Shana np ai ne ates . m bbe then meet NYC-WTC_000073324