NYC 9/11 Public Portal Document
ENVIRONMENTAL SERVICES SAMPLE SUBMIS
Q WESTCHESTER COUNTY LABORATORIES AND
2 Dana Road, Valhalla, New York 10^g
MBa^a
Time/DateSet: , /Y l^hnATP
/5K fen a
Sample Type (circle one):
^^otabie 3. Non Potable Tre^ed^ ft; } B ; ' ■' .Bpttle;#>:,
, 2. Noh Potable - -ft ft4.0ther'ft JLftft^^
S' •Time/Date CollaiCted:'--:
Coller^Byt^ft
f
Agency Ct^e:ft
s
Collected From:
Loda^’^riOd^l’s'Nahle \ •' . Name/Companv ft , _______
>•
'street - '
I city/stgip
City/St/Zip ' ; I
Identiflcatlon of Source
Collodion Point. ■ r CA,CH,
BACTERIOLOGICAL ANALYSIS Lab#:
'Lab#:
_ Heterotrophic Plats Count
(hemodlal^is & all others)
__ Coliform P/A (Public supplies)
__ Coliform MPN (priv well, raw, stp)
ORGANIC POTABLE ANALYSIS
_Tjihalomethanes (524)
jg^olatile Halocarbons (524)
□.Volatile Aromatics (524)
I
I
_ Fecal Coliform (all samples)
Microscopic
Macroscopic
_ Total Trihalomethane Potential (510)
_ Microextractables (504)
_ Pesticides/PCB screen (508)
__ ^'PCB as Decachloroblphenyi (508A)
*saKS»wr*’;.';.
_ ARI
Other, "-i ■ ■■ ; __ Herbicides (515)
fe Refrigerated?
/5W®sasi«l
__ Pesticides (525) /
yes ho _ Carbamate Pesticides (531)
Chlorinated;? yes no _ Glyphosate (547)
87 _Dlquat (549)
ft Free Chlorine Res: mg/L __ Chlorination Disinfection Byproducts (551)
Total Chlorine Res:mg/L _ Haioacetlc Adds (552)
_ Other Pesticides (SM18/8630) .
S'ft;. pH _____
_UCMR List 1
-’5' V ZZZZZ2ZZXZSS
RADIOCHEMICAL ANALYSIS _MtBE Only (524)
Radon
_ Other
I INORGANIC ANALYSIS REQUESTED - Lab#: _
ZZSSSZZZZS
Color ;ftY,;-: y'- _'A^ty'YV, ; / ftfeg^
_ Turbtdtty _ All^lnity ■ ';
I
i
— pH '
X CPhductiVity Z ; ft< ft <
_Brdhiide,
Bropiate/Chlorate/Chlorite J^dhum. _■
Corrosivity (temp:®C) _ Chloride ' beryllium , ...
5-/'
_ BOD(5 day) ;
_ Carbonacoous BOD (5 day)
_ Soluble BOD (5 day)
__Cyanlde
_.Fl«^ride/
_ Hare^e^i total as CaCOa Caldum,-. bo CaCOs
aMBiOi
sal
_ Chemical Oxygen Demand _ Nitrogen. Ammonia as N _ CgIduihrGb*^iBSW:W'ft HSi
_ Dissolved Oxygen _ Nitrogen, Nitrate as N
Total Organic Carbon _ Nitr^en'liltrite as N —premium. Hexavalent
i_ TotalOrganIc Halides _ Nitrogen, Total Kjeldahl as N ±r^balt ft
_ Solids’, Percent (%)
_ Solids, Settleable
2%J.^-ft-^s
Phenol jbef^S^nft'/-..
_ Solids, Suspended _ Phosphorus Total as P / ftjk-<ead
±_ Solids, Total \ _ Phosphorus, Ortho as P - , ^’^^nesIuin;M^iftftftY->t
__ Solids, Total Dissolved ._'Su^'ft, ■
_ /^d8. Total Volatile .__ Surfactants ''.■•■.jwM|iWJry'‘?^
iLxOther ft.-'
.-SW: Yft: -. ft- . fs3«w9W:^i
NYC-WTC_000074340
OCR can misread numbers and units. Confirm readings against the page image before using them.