NYC 9/11 Public Portal Document
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"i ENVIRONMENTAL SERVICES a
2 Dana Road, Valhalla, New York 10596
(914)231-1820 Fax (914) 231-1772 - r,; _ NYS-ELAPNo.tlQ1Q8.;l
> Tirne/Date Set: ______ , / • -FQirri A-rotf^JO/QI) T
S^iaiyp^rdeone,: 1
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I.Potablep*^ 3. Non Potable Treated Bottle #'s: ItfiS2 ill
j_________
I 2. Non Potable ' 4. Other ____ _______ Chain of Custody?____________________ Yes^^No
TlhleflJate Collectsd: g______Comments:______________ ?
’ , ' ' " .
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Coltecteti By: .AgencyCode: PWS #:Source ID: __Y_Type, Descriptor. __ I'
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Locatlon’s/lndividual’s Name yKWiC , R" ' - " VNarhe/Ct^lSa-Bl I
.Street Z I
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II' ■/■Idetrtlflradon of'Source
Collection Point
CA.CH.-BI? '
====3^======^^
S' Lab#:i
BACTERIOLOGICAL ANALYSIS
Lab#:____________
ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS
f Heterotrophic Plate Count
.(hemodialysis & allothers)
Coliform P/A (Public supplies)
_ Co!iform MPN (priv well, raw, stp)
‘'_Tj^alomethanes (524)
_i*^atiie Halocarbons (524)
ij*Volatile Aromatics (524) V
. _ Purgeable Halocarbons (624/8280)
■yi;j^r8e^ble^Arornas";{824(^
. _ Acrolaln & Acr3/lonitrlle
Fecal Collform(a|l samples) __ Total Trihalomethane Potential (510)
_ Mlcroextractables (504) _ PCB's (Arochlors) (608/8081) ’
* _Microscopic __ PestIcides/PCB screen (508)
i^Wacroscoplc
__ PCB as Decachlorobiphenyl (508A)
I
■^W '
_ Herbicides (515)
_ other: __________
_ Pesticides (525)
I
Refrigerated?__ _yes no
Chlorinated:? i__ _yes __ no
Free Chlorine Res: mg/L
_ Carbamate Pestiddes (531)
_ Glyphosate (547)
_Diquat (549)
_ Add Extractables (625/8270) ;
X. Bgs© Neutral Extractables (625/8270)
.^iCGC/MS Unknown Scan -- 5' I
I Total Chlorine Res: _____ mg/L _ Chlorination Disinfection Byproducts (551)
_ Haloacetic Acids (552)
:PWh«^-0<^
__ ;.Othef:? S
SI
'pHa3X-_____ / . _Other Pesticides (SM18/6630)
_UCMRList1
/RADIOCHEMICAL ANALYSIS _MtBE Only (524) ' — ' 1 -
_^Radon ./IV
I. J- Other
Irf-
INORGANIC analysis REQUESTED * Lab#:
:2-^rSdIty Potassium ' ' -
_ Acidity iminum
A - Alkalinity IhlPny
/^;pH.i;<;;i/ __ Bromide '“Jc ....
Conductivity
; /Y Corrosivity (temp: °C)
_ Bromate/Chlorate/Chlorlte
_ Chloride
im
,,Jlium
__^adtum
a
?■ BOD (5 day) 1
iY Carbonaceous BOD (5 day)
__ Cyanide "
_ Fluoride
■_L.BQp3n" ■
_^i^dmlum ;
' .f
/M SolubleBOb (5day) __ Hardness, Tq^as CaCOa ^Caldurt^ as CaCOa
_ Chemical Oxygen Demand _ Nitrogen, A^nia ad N _Cdclum, Ca*2 <
Yi Dissolved O)^en __ Nitrogen, NItrate as N J^^eCnroniiurfi,.Ttota! .
_ Total Organic Carbon
Total Organic Halides
UL. Solids, Percent (%)
__ Nitrogen, Nitrite as N
_ Nitrogen, Total Kjeldahl as N
^ 011 and Grease
^ Chromium, Hexavalent
_Semi-vlolat!les;.
■Llipestk^d^Cffs^ a
_Solids, Settleable __ Phenol ' ■ ^frcLP-Metals ; , g
Solids, Suspended Phosphorus Total as P
_ Solids, Total 2_ Phosphorus, Ortho as P _^agnesium
u_' solids, Total Dissolved £_ SuMates Je^anganese
'-1; 1 ‘ I--.
__ Surfactants
-sjasrr.. ■ •. Y
NYC-WTC_000074318
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