Chain of custody form, NYC DEP sample AE05031, Mar 2002

NYC 9/11 Public Portal Document r/ - • (Y:;; /< environmental SERVICES SAMPl£SUBMISSl8W/OTiHI” «' »ws8a fejitifi westchestercouNtylaboratowesanB Research 2 Dana Road. Valhalla. New York. 10595 (914)231-1620 Fax(914)231-1772 ' 81.- MWi • ' NWMBB «5. ttl :S *^i;^^Bl»|!<;T!i^.;.(drde.one): ■.. . y .

1 3. Non Potable Treated £_■ ?Ct^ri € - i «/'Y Comments:_______ _ __________________ L________ L-J h PWS #: Source ID:Type Descriptor: 11 ' ^^^ C^tostod Froiri' ■ ' I ^^O&^i^i^wal’s Name Name/Company_________________________ . * alW^' ~ Of. ' street ___ ^ip_jZ£jAi_^i City/St/Zip_ on of Source . .... „ Phone#: l'C& Point I CA,CH, Bl? _Ch^^----- Amount$ 8 I tflRlOLOGlCAL ANALYSIS Lab#:____________ f '" Y 'f ' • : ORGANIC POTABLE ANALYSIS c Plate Count & aU others) bX^ltfonn P/A (Public supplies) __ Trihalomethanes (524) / .Volatile Halocarbons (524) .jas^olatile Aromatics (524) I jnoMPN (priv well, raw, stp) « 3LColiform(aH samples) _Total TrihaIomethane potential (510)

pi TOSOSpiC _ Microextractables(504) Pestiddes/PCB screen (508) ___ PCB as Decachlorobiphenyl (508A)^/ _ Herbicides (SMI8/6630,8151) - Y -

^Herbicides (51^ X C ■ 3 _ Pesticides (525) __ Carbamate Pesticides (531) ?> __ Glycols In Water ’ 'Acid -BdiiabaBIS^iiB^fea^^ ■ 1 hated:?------yes no _Gl^hosate (547) _ Base Neutral Extractabtes (625/8270) , ' Re8:_____ mg/L _01quat;(549) ■ < _ Chlorination Disinfection Byproducts (551) ^C/MS Unknown scan', _ Phthalate8 (606MS) ’ ' , I ■4? JJhlorine Res: _____ mg/L __Haloacetlc Acids (5S2) ■■ ' OtherOLLYS%^^^ I? H __ Other Pesticides (SM18/6630) _^UCMRlJ8t1 3 < - : ;ggg]g;]g|gggMi3f: y y Y IOCHEMICAL ANALYSIS SS.;Y?-' _MtBE Only (524) .."■■ fb,?-.?,*-'j-', -•>■’ ■ '. x'- -■‘,S* .<•

sb 1 ■,.L—I-;: lNIG ANALYSIS requested . Lab#: I ' ' ..Acidity 2L Alkalinity ) ; b i' .LYyXX /■ Y/'Y .Jjl^tnony ? ; J _8ramate/Chlorate/Chlorite _ Chloride __ Cyanide _^,3.&rium .j^erylllum _ Boron - ® • ■' II __ Fluoride .-Cadmium

I ,;YL;SLO^nIcCarbon ;.?■..; _ Nltrogen, Nitrite as N Y; ; " _^rotnlum. Total ? L_^h)fnlum, Hexavalent - -.-Tn '' :'- '•'/i-'L'' - i'3 I i^a|&et^an<^^bY'., _ Nitrogen, Total igeWahl as N .i-Cobalt ’ „Semi-vlolaaies „Pesticides/PCB's fczW&rti^’ Oil and Grease _ Phenol , .popper □^Iron, TCU 4’ - Phosphorus Total as P ■ _>tead __ Phosphorus. Ortho as P _ Magnesium . '•‘-A- ■I lilSObY — __Surfactants uUitenganese fS I .OB’? Lib fSMWWWA’-Y-l. ii NYC-WTC_000074631