Chain of custody record, Westchester County Labs, Feb 2002

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMIS^ShFHbRgSl A 10= sster bO ov.com WESTCHESTER COUNTY LABORATORIES AND RESEARCH I 2 Dana Road, Valhalla, New York 10595 (914)231-1620 Fax (914)231-1772 D N^-ELAP No. 10108 Time/Date Sei: /^rm A-70 (rev. 10/01)-

Sample Type (circle one); (T^otable 3. Non Potable Treated Bottle #'s: . 2. Non Potable 4. Other _ ___________________ ______ Chain of Custody?___ Yes___ No Time/Date Collected; An 12- - - O 2- Comments: Collected By:___________ Agency Code; PWS #:______ Source ID: Type Descriptor: Collected From: Bill to: Location’s/lndividual's Name Name/Company Street_________________ Street_______ City/St/Zip_____________ City/SUZip Ideniificatlon 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 (hemodialysis & all others) __ Trihalomethanes (524) __ Purgeable Halocarbons (624/8260) __ Coliform P/A (Public supplies) __ Volatile Halocarbons (524) ,_ Purgeablo Aromatics (624/8260) __ Coliform MPN (priv well, raw, stp) __ Volatile Aromatics (524) __ Acrolein & Acrylonitrile (6260) __ Fecal Coliform (all samples) __ Total Trihalomethane Potential (510) __ Organochlorine Pesticides (606/8061) __ Microscopic __ Microextractables (504) __ PCB's (Arochlors) (606/8081) I __ Macroscopic __ Pesticides/PCB screen (508) _ Herbicides (SMI8/6630,8151) _ API __ PCB as Decachlorobiphenyl (506A) _ Other Pesticides (SM18/6630) __ Other:____________________ _ Herbicides (515) __ Petroleum Hydrocarbon Scan (310-13) __ Pesticides (525) __ Glycols in Water I Refrigerated?yes___ no __ Carbamate Pesticides (531) __ Acid Extraciables (625/8270) Chlorinated:?yes___ no __ Glyphosate (547) _ Base Neutral Extractables (625/8270) __ Diquat (549) Cx-GC/MS Unknown Scan Free Chlorine Res;mg/L __ Chlorination Disinfection Byproducts (551) __ Phthalates (606MS) I Total Chlorine Res:mg/L __ Haloacetic Acids (552) __ Other___________________________ I I pH ___________ _ Other Pesticides (SM18/6630) _UCMRList1 RADIOCHEMICAL ANALYSIS _ MtBE Only (524) __ Radon __ Other____________________ I INORGANIC ANALYSIS REQUESTED - Lab#; __ Color __ /Acidity J^fAluminum __ Potassium __ Turbidity __ Alkalinity Ji; Antimony _i::fSel0nium I _ pH __ Bromide Arsenic _!< Silver __ Conductivity __ Bromate/Chlorate/Chlorite Barium __ Sodium __ Corrosivity (temp:. ’C) __ Chloride . Xi Beryllium .^Thallium _ BOD (5 day) __ Cyanide __ Boron __ Vanadium __ Carbonaceous BOD (5 day) __ Fluoride __ Cadmium >--Zinc __ Soluble BOD (5 day) __ Hardness, Total as CaCOs __ Calcium, as CaCOj "CLP __ Chemical Oxygen Demand __ Nitrogen, Ammonia as N. __ Calcium, Ca'^’ _ Melals/CN __ Dissolved Oxygen __ Nitrogen, Nitrate as N y/'Chromium. Total __ Volatiles __ Total Organic Carbon __ Nitrogen, Nitrite as N jfOhromium, Hexavalent __ Semi-violatiles __ Total Organic Halides __ Nitrogen, Total Kjeldahl as N ^iCobalt __ Pesticides/PCB’s __ Solids, Percent (%) __ Oil and Grease Copper _ Solids, Settleable __ Phenol «--lron __ Solids, Suspended __ Phosphorus Total as P _:y=-Lead I£L£ _TCLP-Metals __ Solids, Total __ Phosphorus, Ortho as P __ ^Magnesium __ TCLP-Pesticides __ Solids, Total Dissolved __ Sulfates 2ifManganese __ TCLP-Herbicides 1 __ Solids, Total Volatile __ Surfactants Mercury _ TCLP-Volatiles __ Other _ UV254 Molybdenum __ TCLP-BNA’s vzNickel

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