Chain of custody record, Westchester County Labs, Feb 2002

NYC 9/11 Public Portal Document ! '■ .................................. t. - V t. •* ‘J A C Co ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM^ WESTCHESTER COUNTY LABORATORIES AND RESEARCH 4^. 2 Dana Road, Valhalla, New York 10595 r ' I * I (914)231-1620 Fax (914) 231-1772 ] ■

1 ■' ; NYS-ELAP No. 10108 1 Time/Date Set: - 1 Form A-70 (rev. 10/01)

•X Sample Type (circle one):^ ' e " ~ Sy st fl/Potable^ 3. Non Potable Treated Bottle #’s:

2. Non Potable 4. Other __________ Chain of Custody?Yes _:__ No ’

YTime/Date Collected: Comments: * . । r , ‘ V /•' Agency Code:__ 1 r . Collected By: PWS #:_______ Source ID: Type Descriptor: L t’ i ' Collected From: Bill to: ’ 1

•^Location's/lndividuars Name _ 'Name/Company 1 Street ■ ■ Street.________ I

City/St/Zip _ ______________ L_ City/St/Zip 4

A Identification of Source / t Phone#: t J Fax#: *'■ Collection Point CA,CH, Bl? Y. Check#:' Amounts' I

BACTERIOLOGICAL ANALYSIS Lab#: Lab#; ‘ - ... I ORGANIC NONPOTABLE/SOLID ANALYSIS ORGANIC POTABLE ANALYSIS '_L Heterotrophic Plate Count ’ __ Trihalomethanes (524) s ____ Purgeable Halocarbons (624/8260) (hemodialysis & all others) __ Volatile Halocarbons (524) __ Purgeable Aromatics (624/8260) Conform P/A (Public supplies) L-- - Coliform MPN (priv well, raw, stpj __ Volatile Aromatics (524) . __ Acrolein & Acrylonitrile (8260) _ Fecal Coliform (all samples) , __ Total Trihalomethane' Potential (510) 2_ Organochlorine Pesticides (608/8081) __ Microextractables,(504) __:‘PCB’s (Arochlors) (608/8081) , _ Microscopic __ Pesticides/PCB screen (508) _ Herbicides (SM18/6630,8151) ,_i? Macroscopic _1 PCB as Decachlorobiphenyl (5p8A) _-Other Pesticides (SMI8/6630) — API other:'___________ ' ' __ Herbicides (515) __ Petroleum Hydro'carbon. Scan (310-13) __ Pesticides'(525) __ Glycols in Water Refrigerated? ’yes no __ Carbamate Pesticides (531) j_ Acid Extractables (625/8270) _ Glyphosate (547) /_ Base Neutral Extractables (625/8270) Chlorinated:? ; yes___ no . '_i;f^C/MS Unknown Scan . _ Diquat (549) Free Chlorine Res:'' / mq/L

fr __ Chlorination Disinfection Byproducts (551) ■ -- Phthalates (606MS) Total Chlorine Res:'Z^l mg/L _2. Haloacetic Acids (552) , _ ' Oth'er:^________________ YA,' pH—----- i _ Other Pesticides (SM18/6630) _UCMRList1- t. I RADIOCHEMICAL ANALYSIS _ MtBE Only (524) ; T Y ft.- Radon 1 i: ■ 1 Other J

INORGANIC ANALYSIS REQUESTED - Lab#: .A/', I rv Jl'Aluminum* 1

Color , __ Acidity f I__Potassium __ Turbidity __ Alkalinity _!>)’Antimony 4-^ Selenium -__ ’ pH __ Bromide Ail'Arsenic I’ Silver w "_1_ Conductivity __ Bromate/Chlorate/Chlorite Bariurh t 4 r __Sodium fit, __ _ Corrosivity (temp: .°C) ___ Chloride Beryllium I Ls'Thallium BOD (5 day) ;r __ Cyanide > __ Boron "__ Vanadium __ Carbona'ceous'BOD (5 day) t- _ Fluoride ,■ __ Cadmium ■; ■ 1 -"Zinc _J Soluble,BOD (5 day) , ' ’ Hardness, Total as CaCOa __ Calcium, as CaCOs , pCLP ‘ Chemical Oxygen Demand Nitrogen, Ammonia as N Calcium, Ga*^ __ Nitrogen, Nitrate as N / _Metals/CN __ Dissolved Oxygen * .ll'Chromium," Total j । ;__ Volatiles Total Organic Carbon __ Nitrogen, Nitrite as N ___ Chromium, Hexavalent I -l_ Semi-violatiles Total Organic Halides- _ Nitrogen, Total Kjeldahl as N Cobalt ‘ Pesticides/PCB’s __ Solids, Percent (%) __ Oil and Grease "i>r. Copper J Solids, Settleable ___Phenol ’ ‘ Iron TCLP -__ Solids, Suspended __ Phosphorus Total as P , C'^-'Lead J_TCLP-Metals _ Solids, Total 1_ Phosphorus, Ortho as P __ Magnesium i_ TCLP-Pesticides 2_' Solids, Total Dissolved _ Sulfates , ^'Manganese ___ . Solids, TotarVolatile. ■__ TCLP-Herbicides 2't __ Surfactants --"Mercury f __ TCLP-Volatiles Other: __________ ■ .UV254 Molybdenum { JrfNIckel ‘ L !_ TCLP-BNA’s ■t • t 1. I-- NYC-WTC_000073573