Chain of custody record, Westchester County Labs, Feb 2002

NYC 9/11 Public Portal Document (■

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ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ''lA-AsA ■ WESTCHESTER COUNTY LABORATORIES AND RESEARCH

. 2 Dana Road, Valhalla, New York 10595 (914) 231-1620 Fax (914) 231-1772 ■4? O/ ■ I ?—« 1 .. pT

NYS-ELAP No. .10108 ?' 1 Time/Date Set: Form A-70 (rev. 10/01 a Sample Type (circle one); ii'

-^ l. Potable 3. Non Potable Treated Bottle.#’s: ' ' ■ • / -5 2. Non Potable Time/Date Collected: 4. Other Chain of Custody? Comments: Yes No t 4 Collected By:< Agency Code: • PWS #: Source ID: Type Descriptor: 2^; • • 4..

Collected From: Bill to: "A •S -I-

Location’s/lndividual’s Narne Name/Company I if' ?!■'• Street ______________ Street__________ i City/St/Zip: City/St/Zip I Identification of Source " Phone#:________ Fax#: ' ir- Collection Point / A - I CA,CH, Bl?t I4 Check#: Amounts ) T -1 uW- 1 BACTERIOLOGICAL ANALYSIS Lab#: Lab#: ‘ .. ■ ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS ' 1' ! __ Heterotrophic Plate Count __ Purgeable Halocarbons (624/8260) j S A 1 F (hemodialysis & all others) j_Trihalomethanes (524) f __ Volatile Halocarbons (524) _ Purgeable Aromatics (624/8260) ' “ A'A, I 1 __ Coliform P/A (Public supplies) __ Coliform MPN (priv well, raw, sip) __ Volatile Aromatics (524) __ Acrolein & Acrylonitrile (8260) i. - __ ‘Fecal Coliform (all samples) ■__ Microscopic __ Macroscopic Total Trihalomethane Potential (510) __ Microextractables (504) __ Pesticides/PCB screen (508) __ Organochlorine Pesticides (608/8081) _ PCB’s (Arochlors) (608/8081) _ Herbicides (SMI8/6630,8151) AT’ 5 _ API ' / ’ __ PCB as Decachlorobiphenyl (508A) , ■_ Other Pesticides (SM18/6630) ,, -.j, - ' "’, ..; __ Other:''. * . __ Herbicides (515) __ Petroleum Hydrocarbon Scan (310-13) .A __ Pesticides (525) i _ Glycols in Water | 4'^• Refrigerated?yes'no ■__ Carbamate Pesticides (531) __ Acid Extractables (625/8270) __ Glyphosate (547) _ Base Neutral Extractables (625/8270) , ,T .: ! Chlorinated:? 4 yes no ' __ Diquat (549) XgC/MS Unknown Scan Free Chlorine Res:J mg/L __ Chlorination Disinfection Byproducts (551)' Phthalates (606MS) Total Chlorine Res: mg/L Haloacetic Acids (552) _ Other:________ ;________ J pH * ' __ Other Pesticides (SMI8/6630) _UCMRList1 A a I;' 'i' • RADIOCHEMICAL ANALYSIS _ MtBE Only (524) ___ Radon . .1

__ Other *_______ 1 A. a “W INORGANIC ANALYSIS REQUESTED - Lab#: A, ’ ■’ [ ■ f ■ __ Color , __ Acidity _ Aluminum __ Potassium r--. A.'t __ Turbidity __ Alkalinity ' Antimony ‘ Selenium .. -C" _ pH __ Bromide ___Arsenic _v Silver 1 __ Conductivity , _ Corrosivity (temp:. ' _ BOD (5 day) _°C) _L Bromate/Chlorate/Chlorite __ Chloride _i_ Cyanide < Barium ^■Beryllium’ __ Boron __ Sodium Thallium 1 ‘ ■j a .1. __ Vanadium 1 - Carbonaceous BOD (5 day) __ Fluoride __ Cadmium _'Zinc « _ Soluble BOD (5 day) __ Hardness, Total as CaCOa __ Calcium, as CaCOa CLP ■ “ I Chemical Oxygen Demand !,__ Dissolved Oxygen __ _ Nitrogen, Ammonia as,N __ Calcium, Ca*2 ‘ _ Metals/CN I ■’a; __ Nitrogen, Nitrate as N __ Chromium, Total __ Total Organic Carbon _ Volatiles __ Nitrogen, Nitrite as N __ Chromium, Hexavalent ' '■'5 __ Total Organic Halides __ Nitrogen, Total Kjeldahl as n’ __ Cobalt Semi-violatiles I __ Pesticides/PCB’s I ,__ Solids, Percent (%) __ Oil and Grease _Copper __ Solids, Settleable^ __ Phenol __ 'Iron J I »• I __ Solids, Suspended ' TCLP •I __ Phosphorus Total as P __ ;■ Lead ;__ Solids, Total '__ Solids, Total Dissolved ; __ Phosphorus, Ortho as P ■ __ Sulfates __ Magnesium __ Manganese _TCLP-Metals T__ TCLP-Pesticides __ TCLP-Herbicides I a' ■__ Solids, Total Volatile __ Surfactants . Other: . ' r'l_________ _ _ UV254 __ Mercury ' _ TCLP-Volatiles ■a .Jr'Molybdenum _TCLP-BNA’s Nickel

‘‘nYC-WTC_060073479