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Chain of Custody Record, Sample AE03798, Feb 2002

Machine-extracted title · confidence 90%

Document tracking the custody and transfer of water samples submitted to Westchester County Department of Labs & Research.

NYC-WTC_000073825–000073829

Folder label: “AE 03798

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Scanned page image, NYC-WTC_000073828
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NYC 9/11 Public Portal Document Westchester gov.com ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914)231-1620 Fax (914) 231-1772 Time/Date Set: Sample Type (circle one): (Potable 3. Non Potable Treated 2. Non Potable 4. Other Time/Date Collected:0840 2-14-02 Collected By: L. Wagner Agency Code. - Collected From: Location's/Individual's Name NYC DEP Street 19 Wesilove Drive City/StZip Valhallo Ny 10595 Identification of Source Collection Point De l Q.692 a 1270 P•1285 P.IS2S Bottle #s: C-1566 KiB K Chain of Custody? Yes No Comments: PWS#: - Source ID: Billto: Name/Company - Street City/St/Zip Phone#: CA,CH, BI? BACTERIOLOGICAL ANALYSIS Lab#: _ Heterotrophic Plate Count (hemodialysis & all others) Coliform P/A (Public supplies) Coliform MPN (priv well, raw, stp) Fecal Coliform (all samples) Microscopic Macroscopic API Other: Lab#:_ ORGANICPOTABLE ANALYSIS Trihalomethanes (524) Volatile Halocarbons (524) Volatile Aromatics (524) Total Trihalomethane Potential (510) Microextractables (504) Pesticides/PCB screen (508) PCB as Decachlorobiphenyl (508A) Herbicides (515) Pesticides (525) Refrigerated? yes Chlorinated:? yes Free Chlorine Res: Total Chlorine Res:_ pH a nо _ по _mg/L mg/L Carbamate Pesticides (531) Glyphosate (547) Diquat (549) Chlorination Disinfection Byproducts (551) Haloacetic Acids (552) Other Pesticides (SM18/6630) UCMR List 1 RADIOCHEMICAL ANALYSIS MtBE Only (524) Radon Other INORGANIC ANALYSIS REQUESTED - Lab#: _ Color Turbidity рH Conductivity Corrosivity (temp:°C) BOD (5 day) Carbonaceous BOD (5 dav) Soluble BOD (5 day) Chemical Oxygen Demand Dissolved Oxygen Total Organic Carbon Total Organic Halides Solids, Percent (%) Solids, Settleable Solids, Suspended Solids, Total Solids, Total Dissolved Solids, Total Volatile Other: - Acidity Alkalinity Bromide Bromate/Chlorate/Chlorite Chloride Cyanide Fluoride Hardness, Total as CaCO3 Nitrogen, Ammonia as N Nitrogen, Nitrate as N Nitrogen, Nitrite as N Nitrogen, Total Kjeldahl as N Oil and Grease Phenol Phosphorus Total as P Phosphorus, Ortho as P Sulfates Surfactants UV254 Antimony Arsenic JBarium Beryllium Boron LCadmium Calcium, as CaCO3 Calcium, Ca*2 /Chromium, Total Chromium, Hexavalent Cobal Coppe KIFon Lead Maonesiumr -Manganese Mercury Molybdenum Nickel NYC-WTC_000073828 nelc NYS-ELAP No. 10108 Form A-70 (rev.10/01) 174 K 175 и 188 Type Descriptor: Fax#: Check#: Amount$ ORGANIC NONPOTABLE/SOLID ANALYSIS Purgeable Halocarbons (624/8260) Purgeable Aromatics (624/8260) Acrolein &Acrylonitrile (8260) Organochlorine Pesticides (608/8081) PCB's (Arochlors) (608/8081) Herbicides (SM18/6630,8151) Other Pesticides (SM18/6630) Petroleum Hydrocarbon Scan (310-13) Glycols in Water Acid Extractables (625/8270) Bese Neutral Extractables (625/8270) GC/MS Unknown Scan _ Phthalates (606MS) Other: Potassium -Selenium ySilver Şodium Thallium Vanadium V Zinc CLP .Metals/CN Volatiles Semi-violatiles Pesticides/PCB's TCLP _TCLP-Metals L TCLP-Pesticides _ TCLP-Herbicides - TCLP-Volatiles TCLP-BNAS

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NYC-WTC_000073828Source: NYC Law Department, mirrored locally

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