Chain of Custody Record, Westchester County Lab, Feb 2002

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM^^ <com ;WlE^CHESTBRWy*^tY.UKBOR^RI^'Aj^S|Oi^HM 2 Dana Road, vaihalla. New Vbrk 10695 -'y/' PrI M I# . -fft'-■ftC^O1-W,;Fax'(914)231-i772ft^ aiSi B Tlme/Date Set: 3 3 Sarn^^W (circle one):

t dl> P<^ble J ' Non Potable 3. Non .Potable Treated 4. Other Chain ofCustody? __ Yes I Time/Date Collected:,L__ZE3 T.... ft: Cpliecteid By:' __ii. Agency Gode: PWS #:___ Lsou^id:----------

aaftaa'....-"la'ssawwwws ag«»«g8 I Collected From: .Sill. toCugi'f;- if . Locatlon’s/lndlvidual’s Name: Name/Company 'V Street ■a ft '

fi Clty/St/Zlp_ ZZZ_ZZZ_HZZZ___ZZZ~Z_ Clty/St/Zlp_i ZZZZZZxSSSi I A,Identification Collection Point of Source1 \'A fi ft '' Phone#: __AiiSLLL rCA,CH,BI?

BACTERIOLOGICAL Analysis Lab#: /'fi; Yt-Ssa::^ I ORGANIC POTABLE ANALYSIS ORGANICNONPOTABLE/SOLID ANALYSIS ;X Heterotrophic Plate Count __ Trihalomethanes (524) {hemodialysis A all others) S' Coliform P/A (Public supplies) Coliform MPN (priv well, raw, stp) _j^'Volatile Halocarbons (524) _tr<olatile Aromatics (524) PuiiRabte.Aibttiajia;?{®<^ — Acrolein A Acrylonitrfle (826^) . ' i , __ Fecal Coliform (all samples) _ Total Trihalomethane Potential (510) _ Organochlorine Pesticides (608/8081) ftftft Micrdacopic _ Microextractables (504) PCB’^^m^te)..'W^fil^)W'-a^ ft -ftft.-AP|fi. ^Macroscopic _Pesticides/PCB screen (508) __ PCS as Decachlorobiphenyl {508A) _ Herbicides (SMI 8/6830,8151) _ Other Pesticides (SM18/6630)

I I Other.

Free Chlorine Res: ■

yes - . Refrigerated?__ _yes___ no aSSorinated:? no mg/L Ti^l chlorine Res: _____ mg/L 2_ Herbicides' (515) __ Pesticides (525) _ Carbamate Pesticides (531) _ Glyphosate (547) ,— Diquat (549) _ Chlorination Disinfection I^Mucts (551) __ Haloacetic Acids (552) ft^ : __ Petroleum Hydrocarbon Scan (310-13)

_ Acid Extractebles (825/8270) . __ Base Neutral Extractablas (625/8270) _<--GC/MS Unknown Scan _ Phthalates (606MS) J Ir RADIOCHEMICAL ANALYSIS __ Other Pesticides (SM18/6630) _UCMRLIst1 _MtBE Only (524)

I 'fi i£Radon _3pther ' ft '-'a' '' I INORGANIC ANALYSIS REQUESTED - Lab#: _ Color'• ■ _/Addity _js.''Alumlnum , 'fi- ■'' A' -

o Turbidity _ Alkalinity txl^timonv

« Corlduc^ity Corrosivity {temp:. ■’C) _ Brornlde _Bromate/Chlorate/Chlorite _ Chloride - : .^^^Arsenlc/ ^Barium _afBeryllium fift'^iSglS#iii I. i _s BOD(5day) __ Cyanide _i^ron : W Carbonaceous BOD (5 day) _SolubleBOD(5 day) _ Chemicat Oxygen Demand ..^Fluoride'3 _ Hardness, Total as CaCOa Nlht^en, Ammonia as N jiCa^nilum 3i Caldum, as CaCOs _ Calcium, Ca*2 i^iisssfeisisi '¥ _□ DissolveOx^en ■/ fijlbtel Organic Carbon __ Nltrogen, Nitrate as N _ Nitrogen. Nitrite as N _j-iChromlum, Total _ Chromium, Hexavalent ; > s Total Organic Halides

t YlSpllds, Solids, Percent (%) Settleable SqIIPs. Suspended _ Nitrogen, Total Kjeldahl as N _ Oil and Grease __ Phenol _ Phosphorus Total as P . JsrCobalt ^ifCbpper

'351^6^/"'" ■ ‘■ ':aA.:: ft- -TCLR.^ ft'fififtfi/ ".fiftft-fi < ftY^ZS. ■S I _TCLP-Metals I _Sollds, Total _Sollds,Total Dissolved __ Phosphorus, Ortho as P _ Sulfates _6jAManganese ! _TCLP-Pe8tictdes ,W

I a>- /Solids, TbtalYblatlle _±f’ Other _ Surfectants __ UV254 ; -H’eiwry - EsSa:s NYC-WTC_000074294