Chain of Custody Record, Sample AE03822, Feb 2002

NYC 9/11 Public Portal Document

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i- '■ m ACcoa ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM a ..5A:b..td»ter ft ip' •

ft '■ vY Time/Date Set: WESTCHESTER COUNTY LABORATORIES AND RESEARCH . 2 Dana Road, Valhalla, New York 10595 ' ' (914) 231-1620 . Fax (914)‘231-1772 ' ' i . ft -

. 'i , NYS-ELaP No'-10108 ■ J £ X

, ; .YFormA-70(rev.10/01)

Sample Type (circle one): tft 1. Potable 3. Non Potable Treated Bottle #'s: ft-ftftft. 2. Non Potable ' ‘ 4. Other Chain of Custody? l-YesLs- No ■ Time/Date Collected: •_ Tiikiill- Comments: h .-UM

Collected By: Agency Code: Pvys #: -- £i Source ID: ' Type Descriptor: Sft ' Collected From: Bilijo: a" _ Location's/lndividual’s Name Name/Corn'pany 1 ' -I

Ife" Street_________ ___ ^City/SVZip:________________ Street__________ City/St/Zip 2 ■f

L -'ft T F 'Identification of Source Collection Point ■ Phone#: .

- _ I CA,CH, Bl? O' bi- Check#:.. JL L.Tax#:' V. «

' Amounts

ft- BACTERIOLOGICAL ANALYSIS Lab#: rr -2 0^9/2" i Lab#: ft ____________ X_ ORGANIC POTABLE ANALYSIS I 2'Ty . ’; - ■ ft V. ORGANIC NONPOTABLE/SOLID ANALYSIS 2 ' -j

r; XHeterotrophic Plate Count “ (hemodialysis & all others) _ Coliform P/A (Public supplies) __ Trihalomethanes (524) __ Volatile Halocarbons (524) __ Volatile Aromatics (524) ' Purgeable Halcfcarbons (624^26b)'Y ■ X' Pufg'eable Aromatics (624/8260) ■ \ -X.’Acrojein>’Acr^6nitrile (8260)^^ _ / J

_ Coliform MPN (priv well, raw, stp) X Fecal Coliform (all samples) __ Total Trihalomethane Potential (510) , 2 X*'Organpchloririe •Pesticides**(6b8/8081) • 1 r X Microscopic __ ."Microextractables (504) * ■ XftPCB’^(Arochlorsy' (608/8081 )■ ‘ A ’ Y M-

a X Macroscopic _API. __ Pesticides/PCB screen (508) __ PCB as Decachlorobiphenyl (508A) X.,Herbicides‘(SM18/6630:8i51) ’2 Y-s X ;Othet;i^sticideX(SM18/6630) 2.; < iftp" I ft , X Other::

■ Refrigerated?yes___ no __ .Herbicides (515) __ Pesticides (525) * —Carbamate Pesticides (531) __ •' X^ Petroleum Hydrocarbon Scan ■ (316:13)/ X'Gly^ols in Water; .(625/8270). 4 c X?"' 1 __ Glyphosate (547) - //.>6ase Neutral Extractables '(625/8270) ' X a Chlorinated:?'yes /__ no Free'Chlorine Res:ft mg/L _ Diquat (549) ,, . ’ r ' XGC/MS^ Unknown Scan -ft __ Chlorination'Disinfection Byproducts (551) ‘ X Phthalates'(606MS) '“ ' ’ '' Total Chlorine Res: rhg/L __ Haloacetic Acids (552) . Other:T --ftZVft, i- pH.-.'ft _OtherPesticides’'(SM18/6630) " _UCMRList1 ‘ . ' ./'Y ' .ft ’T/• X . 1- X- ' Y ■ RADIOCHEMICAL ANALYSIS _ MtBE Only (524) ' . 2 -■ Radon 1 __ ; Other___________ ' ^,44.

a INORGANIC ANALYSIS REQUESTED - Lab#:. __ Color Acidity *:__ Aluminum ’ ' ' %-t

_Z' Potassium :U‘' a,.‘ _ Turbidity ft- -.-t . __ Alkalinity , , 21_ Antimony ■Yft Selenium ’ - ; ; , —'■pH; ■ .■a .XSiiybrft • C. _ Conductivity " _Bromide , * . _ Bromate/Chlorate/'Chlorite Arsenic , __ Barium , . _j-Sodium ' I- __ Corrosivity (temp:/’C) S; _ BOD(5day) __ Carbonaceous BOD (5 day) Chloride. - __ Cyanide __ Fluoride , -

' *■ ; Beryllium „ Boron" .J • ' ' '* XCadmium/' Xr ^thallium ; Yj.'Vahadium ' ■ ft Zinc ' - ft ‘f I b Soluble BOD (5 day). __ Chemical Oxygen Demand , __ Hardness, Total as' CaCOs ‘ ___ Calcium,"as CaCOa j.' • ■ __ Nitrogen, Ammonia as N Calcium, Ca*^ jY . CLP ; !

X Dissolved Oxygen ,X Metals/CN ft ft-, ■ft' __ Nitrogen, Nitrate as N - XChromium, Total ^ft /; /X Volatiles W; K- __ Total Orgariic Carbon ' __ Nitrogen, 'Nitrite as.N ___ Chromium, Hexavalent ii' - __ Total Organic Halides ■ Solids, Percent (%) __ Nitrogen; Total Kjeldahl as N __ Oil and Grease ' _ Cobalt ■ X Copper X Serhi-violatiles'ft, X Pesticides/PCB's i i __ Solids, Settleable ' __ Phenol ■” /’ ’ _lron , - I- __ Solids, Suspended __ Solids, Total' __ Phosphorus Total as P '.__ Phosphorus,- Ortho as P . _ Lead ,. __ Magnesium ’ ICL£ XTCLP-M^als ft 'ft', ft __'TCLP-Pesticides ft' ___ Solids, Total Dissolved '__ Sulfates _ ’X Manganese __ Surfactants . ' ■ Mercury ‘ 1' _TCLP-Herbicides , __ ■ Solids, Total Volatile i X TCLPYAjIatiles ' /ft . __ Other:■ - __ UV254 - ■ Molybdenum _ Nickel 1, ,_‘TCLP-BNAs: ; ’ ; .. .aV ■"X , -v'. y. "ftV. I

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