NYC 9/11 Public Portal Document
illfflmiiiS«liili»P
laaBS ElaJ ENVIRONMENTAUSERVtCESSAMPLeSUBMtSSIONFpRM 3-'.''4: s
'jss
a £ ;-j 'W
||lKBi«7^77^B7/Xli7 777 ■ ■
iKiTTvXZ^^
' ,1. Potable . 3. Non Potable Treated
5
iW0
Za >^s*-2ZZZw|^SZI^^
hocatlon’s/lndlvidual’s Name _______
.^Street *
,wsBXZZZZZZZZZ=ZZZ
IMM!*^; ...........................
»il^cW,PblntXXXX.
I^C-reRlOtOGICALANAlYSiS
S’ J
' i L-iOollfonn P/A (PubilcBUp^esl X 7
;/2S?3®lSS!SJSS55»^
*>1‘-■Microscopic
■ ''^-^
s ;X,Wacrescoplc _ Pesticldes/PCB screen (508)
■LreB^WWMilbraWpljBiiyl
•7 'iXOth©r;_____________ , . .
X^PlMadea^^i^SSSvA^ 17; 7.': 7 7 Y;7
leWgeraied?yes __ no _CarbamatePesticides (531) - __ AcidExtractables (625/8270) ;
11 I V *
,JiBi^^K-^Xi'yesX—'no; / a. _ Glyphosate (547) _ Base Neutral Emctables (825/5270)
zxsu«-?te±xr-.:'- ■-
_Hak»MllcA0ids (562) o£L .*^^’- - :
_UCMRList1 . PxTZSPZ2j2Z~ZZ
S'd JALANALYSIS
4’--, ;
±ZZZzZZZZZZZZZZ2ZxZ27^HZZ222^
t-; \7.4+Xi' ■(Ox
'3S~ -ss' zsr XsSSm X# 45^1
__ Bromate/Chlorate/Chlorlte __ Barium ’
_gwsr—?
„ BOD(6day) __ Cyanide
__ Pluorlde ;
, __ Boron
__ Cadmium
’ -w-*.
B^^WgQg
^'■
-Z-SSSSg’a’SS,”*’
cww?*- ' Nitrogen, Ammonlaas N
__ Nltrogen, Nltrate asN
XL Nlfr^n, NWiteds N /
_ Calcium, Ca«
./X^^ - 7
; __Chromiura. Hexavalent
^^etails/CN
• ■ awK'-gggaw
__Sem}-vioIatiles
•-.-XoislOrganicHallcles Xx lte^h'Tbtal^l^ ^^Cobalt;/ ' "
It ^.Soifla,Percent {%) __ Oil and Grease __ Copper
s __ ^Ids.Settieabla
Staiae, Suspended
SQlds, Total
_ Phosphorus Total as p/ j
__■ Phosphorus, Ortho as P;
__lron -ry
__ Magnesium
'\
7:W»i
M. SC3«9»^l;WatliB
Sulliates _ Manganese
;__Mtoy /
.rXKSS:
I __ Surfactants
^.;u\^54 - ,
t-t t
^^IVWiWaiurn'
■ '__ Nlckdl; <•';
_TCLP-Volatlles
_TCLP’-SNA's . ,
NYC-WTC_000074390
OCR can misread numbers and units. Confirm readings against the page image before using them.