Chain of custody record, Westchester County Labs, Feb 2002

NYC 9/11 Public Portal Document . - J- ■y •■ • ' - •■ ■.. ’• I ,1 ,1. * - lit AC Co ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ' I J^stchester WESTCHESTER COUNTY LABORATORIES AND RESEARCHk 2 Dana Road, Valhalla, New York 10595 I 1 'I

I'' (91’4) 231-1620 Fax (914) 231-1772 1 I NYS-ELAP No'. 10108 fime/Date Set: ( ’ i , Form A-70 '(rev. 10/01)

Sample Type . (circle one): 1. Potable 3. Non Potable Treated Bottle #’s: 2'/’v/ -t ■ / I ' ' . 22/Non Potable 4. Other Chain of Custody? __ Yes’No ’

I Time/Dafe Collected: Collected By: / L/ j I r >(

Agency Code: Comments: >PWS #: L_____2_ Source ID: '_2 Type Descriptor; Collected From: Bill to: .( Location’s/lndividual’s Name; I Name/Company 1__ L_ ' J . Street ~ r ., Street___________________ _

i City/St/Zip ^Identification of Source - City/St/Zip Phone#: . I-

Fax#: ■* _____ L* 1 Collection Point L Check#:. CA,CH, Bl? *Amount$

o BACTERIOLOGICAL ANALYSIS Lab#: Lab#: -■ J L I. ORGANIC POTABLE ANALYSIS: ORGANIC NONPOTABLE/SOLID ANALYSIS b- _L_' (hemodialysis Heterotrophic Plate Count S ail others) ‘ ’ v y ’__ Trihalomethanes (524)' '■ _ Purgeable Halocarbons (624/8260) I"' .^Coliform P/A /Public supplies)' ___ Volatile Halocarbons (524) _2 Volatile Aromatics 1(524) __ Purgeable Aromatics (624/8260) '■_L Acrolein & Acrylonitrile (8260) Coliform MPN ' (priv well, raw, stp) ■21 Fecal Coliform (all samples) __ Total Trihalomethane Potential (510) _ Organochlorine Pesticides (608/8081) 2__ Microextractables (504) ’r _ RGB’s (Arochlors) (608/8081) ' •' Microscopic • s?. API_2‘Macroscopic __ Pesticides/PCB screen (508) __ PCB as Decachlorobiphenyl (50'8A) _ Herbicides (SMI 8/6630,8151) Other Pesticides (SMI8/6630) , Fa _ Other: 1-' __ Herbicides (515) __ F’etroleum Hydrocarbon Scan (3'10-13) Glycols in Water ’ __ Pesticides (525) • 1.2 Refrigerated? yes no j __L Carbamate Pesticides (531) .Acid Extractables (625/8270) __ Glyphosate' (547) Jl. Base Neutral Extractables (625/8270) Chlorinated:? yes no * _Diquat (549) ’ ’■> ' .ill-GC/MS Unknown Scan ,* K Free Chlorine Res:. ____ mg/L Total Chlorine Res: _ ______ _mg/L __ Chlorination Disinfection Byproducts (551) __ Haloacetic Acids (552) 1_ Phthalates (606MS) _ Other: I ,__________ 1_ •pH':.; ■ _Other Pesticides (SMI8/6630) • * f * . R __ UCMRListl' _MtBE Only (524) ■ 1 r RADIOCHEMICAL ANALYSIS I iRadbn > • -X* 1 I t . Other 1 INORGANIC ANALYSIS REQUESTED Color __ Aaidity Lab#; _L J >

__ Aluminurri 1 ■ i 1 r 1 __ Potassium Turbidity _ Alkalinity __ Antimony . j_Selenium- _ pH - . __ Bromide __ Arsenic (-2_ Silver .t ___ Conductivity y ■' __ Bromate/Chlorate/Chlqrite Barium Sodium '__ Corrosivity (temp: .°C)’ I- Chloride ;__ Beryllium I I __ Thallium BOD (5 day) __ Cyanide __ Boron ' __ Vanadium ,.

aI' ; Carbonaceous BOD (5 day) /^ Soluble BOD (5 day) J. _ Fluoride ■__ Hardness, Total as CaCOa _Cadmium — --I ;__Calcium) as CaCOa I I i CLP Zinc .’ ' J

Chemical Oxygen Demand-fi __ Nitrogen, Arnmonia as N _ _ Calcium, Ca«Y 1 ■ _Metals/CN ___ Dissolved Oxygen. _ Nitrogen, Nitrate as N __ Chromium, Total __ Volatiles ,, ■___Total Organic Carbon _ _ Nitrogen, Nitrite as N '__ Chromiumf Hexavalent __ Semi-violatiles .

fr i_ Total Organic Halides ' Solids, Percent (%) __ Solids',-Settleable -22 Solids, Suspended ■2_'Solids, Total' 1 _ Nitrogen, Total Kjeldahl as N __ Oil and Grease- __ Phenol __ Phosphorus Total as P . __ -Phosphorus, Ortho as P __ Cobalt ^Copper __ Iron __ Lead __ Magnesium; -■ .1 1 __ Pesticides/PCB’s t ICLPJ _TCLP-Metals - -

__ ,TCLP-Pesticides -- Solids, Total Dissolved ___ "■Sulfates : __ Manganese I - - ._TCLP-Herbicides _. Solids, Total Volatile __ Surfactants > _ Mercury _ TCLP-Volatiles. . s' - Other: ________ _ UV254 , t ' __ Molybdenum ■i _ TCLP-BNA’s' i '' __ Nickel ---------------

- 1 . ... ,__ 1 NYC-WTC_OOO673571