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Document / 9 pages

Chain of custody record, Westchester County Labs, Feb 2002

Machine-extracted title · confidence 95%

Document tracking the transfer of environmental samples to the Westchester County Department of Labs and Research.

NYC-WTC_000073502–000073510

Folder label: “AE 03178

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Scanned page image, NYC-WTC_000073505
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NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSICa8i3f^6Kvr 3

1 ■I ester ov.com WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914)231-1620 Fax (914) 231-1772 BSI x y^YS-ELAP No. 10108 _ ’

Time/Daie Set: // FormA-70(rev.10/01)

6? CT Sample Type (circle one): ((57Potabl^ 3. Non Polable Treated Bottle #’s: ‘K I 2. Non Potable 4. Other Chain of Custody?___ Yes___ No Time/Date Collected; ' 7 ' J t- Comments; Collected Agency Code: PWS #:______ Source ID: .Type Descriptor: I Collected From: Bill to; Location's/lndividual’s Name <3 Name/Company Street________ _________________ Street_______ City/SVZip__________ ___________ City/St/Zip Identification of Source Phone#; Fax#; Collection Point_______ CA.CH, Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSIS Lab#: Lab#;_______________________ ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS __ Heterotrophic Plate Count I (hemodialysis & all others) __ Trihalomethanes (524) __ Purgeable Halocarbons (624/8260) __ Coliform P/A (Public supplies) __ Volatile Halocarbons (524) __ Purgeable Aromatics (624/8260) __ Coliform MPN (priv well, raw. stp) __ Volatile Aromatics (524) __ Acrolein & Acrylonitrile (8260) __ Fecal Coliform (all samples) __ Total Trihalomethane Potential (510) __ Organochlorine Pesticides (608/8081) __ Microscopic __ Microextractables (504) _ PCB's (Arochlors) (608/8031) __ Macroscopic __ Pesticides/PCB screen (508) _ Herbicides (SM18/6630,6151) _ API __ PCB as Decachlorobiphenyl (508A) __ Other Pesticides (SM18/6630) __ Other:_______________ ' __ Herbicides (515) __ Petroleum Hydrocarbon Scan (310-13) __ Pesticides (525) __ Glycols in Water Refrigerated?yes___ no __ Carbamate Pesticides (531) __ Acid Extractables (625/8270) J __ Glyphosate (547) __ Base Neutral Extractables (625/8270) Chlorinated:?yes___ no __ Diquat (549) .j^6c/MS Unknown Scan Free Chlorine Res:mg/L __ Chlorination Disinfection Byproducts (551) _ Phthalates {606MS) Total Chlorine Res:mg/L __ Haloacetic Acids (552) __ Other;___________________________ pH ___________ _Other Pesticides (SMI8/6630) _UCMRList1 RADIOCHEMICAL ANALYSIS _MtBE Only (524) __ Radon __ Other____________________

INORGANIC ANALYSIS REQUESTED - Lab#: __ Color __ Acidity '^Aluminum __ Potassium __ Turbidity __ Alkalinity Antimony ^Selenium I _ pH __ Bromide Arsenic ~^Silver __ Conductivity __ Bromate/Chlorate/Chlorite _/Barium __ Sodium __Corrosivity (temp;. ;c) __ Chloride _^eryllium '-thallium _ BOD (5 day) __ Cyanide __ Boron __ Vanadium __ Carbonaceous BOD (5 day) __ Fluoride __ Cadmium _:::Z'2inc __ Soluble BOD (5 day) __ Hardness, Total as CaCOs __ Caldum, as CaCOs OlS __ Chemical Oxygen Demand __ Nitrogen, Ammonia as N __ Calcium, Ca*’ __ Dissolved Oxygen __ Metals/CN __ Nitrogen, Nitrate as N j^Gbromium, Total __ Volatiles __ Total Organic Carbon __ Nitrogen. Nitrite as N __ Chromium, Hexavalent __ Semi-violatiles __ Total Organic Halides __ Nitrogen, Total Kjeldahl as N zTCobalt I __ Pesticides/PCB’s __ Solids, Percent (%) __ Oil and Grease ^Cooper __ Solids, Settleable __ Phenol Iron __ Solids, Suspended __ Phosphorus Total as P -TLead I£kE __ TCLP-Metals __ Solids, Total __ Phosphorus, Ortho as P __ Magnesium __ TCLP-Pesticides __ Solids, Total Dissolved __ Sulfates j^jj^Manganese __ TCLP-Herbicides __ Solids, Total Volatile __ Surfactants j^^ercury xifbther: _ TCLP-Volatiles _ UV254 __ Molybdenum _ TCLP-BNAs Nickel

J___________ SO'd 6016 300C8_g3J NYC-WTC_000073505

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NYC-WTC_000073505Source: NYC Law Department, mirrored locally

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