Chain of custody record, Westchester County Labs, Feb 2002

NYC 9/11 Public Portal Document

'V ENVIRONMENTAL SERVICES SAMPLE SUBMISSION. FORM ' tester WESTCHESTER COUNTY LABORATORIES AND RESEARCH novcom 2 Dana Road, Valhalla, New York 10595 (914)231-1620 Fax (914) 231-1772 t-f,.* "WgOiiiTiwa.i T

NYS-ELAP No. 10108,___ Time/Date Set: Form A-70 (rev. 10/01)

Sample Type (circle one): ,k- , K .< f •-'C/W-t I ^^PotaS^ 3. Non Potable Treated Bowe P '7,. -iff) 2. Non Potable 4. Other____________ Chain of Custody?Yes No ''' Time/Date Collected: fl)'') Comments:_____ ■_ Collected By: O -SZL C 1 I Agency Code: PWS #:__________ Source ID:_______ Type Descriptor: I r Collected From: Bill to: t. Location’s/individual's Name _ p/cjje r Name/Company ' ' street OF-I V C Street___________ City/St/Zip V LL City/St/Zip Identification of Source______ _________________ Phone#:_________ Fax#: Collection Point c IQ I CA,CH, Bl? Check#: Amounts.

I BACTER(OLOGICAL ANALYSIS Lab#: !I Lab#: ___ ____________________ J ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS __ Heterotrophic Plate Count (hemodialysis & all others) __ Trihalomethanes (524) •__ Purgeable Halocarbons (624/8260) __ Coliform P/A (Public supplies) X Volatile Halocarbons (524) __ Purgeable Aromatics (624/8260) 5* Volatile Aromatics (524) __ , Acrolein & Acrylonitrile. (8260) __ Coliform MPN (priv well, raw, stp) __ Fecal Coliform (all samples) __ Total Trihalomethane Potential (510) Orgariochlorine Pesticides (608/8081) __ Microscopic __ Microextractables (504) _ PCB'S (Arochlors) (608/808.1) __ Macroscopic __ Pesticides/PCB screen (508) Herbicides (SM18/663O,8151) _ API __ PCB as Decachlorobiphenyl (508A) __ Other. Pesticides (SMI8/6630) __ Other:_____________________ __ Herbicides (515) __ Petroleum Hydrocarbon Scan. (310-13) __ Pesticides (525) _ Glycols in Water ! Refrigerated?yes___ no __ Carbamate Pesticides (531) _ Acid Extractables (625/8270) Chlorinated:?yes no __ Glyphosate (547) . Base Neutral Extractables ,-(625/8270) 1 , __ Diquat (549) "XGC/MS Unknown Scan '■ Free'Chlorine Res: mg/L __ Chlorination Disinfection Byproducts (551) j_ Phthalates {606MS) Total Chlorine Res: mg/L __ Haloacetic Acids (552) _ Otherij_____________________ _________ _ Other Pesticides (SM18/6630) pH ___________ _UCMR List 1 I RADIOCHEMICAL ANALYSIS _MtBE Only (524) __ Radon ! __ Other____________________ K J INORGANIC ANALYSIS REQUESTED - Lab#: 7 (■ __ Color __ Acidity X Aluminum Potassium. __ Turbidity __ Alkalinity j^Antimony ^Selenium _ pH' __ Bromide XArsenic 2«Silver i __ Conductivity __ Bromate/Chlorate/Chlorite X Barium __ Sodium __ Corrosivity (temp:. °C) __ Chloride XBeryllium .^Thallium _ BOD (5 day) __ Cyanide _feoron Vanadium ! __ Carbonaceous BOD (5 day) __ Fluoride J^^Cadmium 2 Zinc _ Soluble BOD (5 day) __ Hardness, Total as CaCOa __ Calcium, as CaCOa __ Chemical Oxygen Demand ’ __ Nitrogen, Ammonia as N __ Calcium, Ca*^ CLE __ Dissolved Oxygen _ Metals/CN __ Nitrogen, Nitrate as N .2Sphromium, Total. _ Total Organic Carbon _ Volatiles __ Nitrogen, Nitrite as N __ Chromium, Hexavalent I __ Total Organic Halides __ Nitrogen, Total Kjeldahl as N 4 Cobalt __ Semi-violatiles __ Pesticides/PCB's __ Solids. Percent (%) . __ Oil and Grease X Copper __ ..Solids, Settleable ' __ ^’Phenol X Iron __ Solids, Suspended __ Phosphorus Total as P Sbead TCLE __ TCLP-Metals __ Solids, Total __ Phosphorus, Ortho as P _ Magnesium _TCLP-Pesticides __ Solids, Total Dissolved __ Sulfates Manganese _TCLP-Herbicides ?■ :_ Solids, Total'Volatile __ Surfactants X Mercury _ TCLP-Volatiles sZ Other:_____ ____________ _ UV254 2 Molybdenum: _ _TCLP-8NA's 2jslickel ----------- —= NYC-WTC_000073552