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

NYC 9/11 Public Portal Document , ... .. ....... ...................... '77(773;,/ ...................

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B0ffl.r/£W£Zl?^A«aS123feyskffi'’ Chain of Custody?___ Yes___ No I s

I£ I ? {^leded Bv?/ - 52t* ^nev Code:_________ <1 >L/T^^y PWS #:___________ Source ID: . Tvoe Descriptor___ 1 ? 6O(le^S^?7;?7;77,7’.;,;,7,,;, ;■/ i I fftroe'jBSI&kJSKiB_____________ B■ ,, 7.. Name/Company __7______ 1

r ■■ gHy/s^p' "'7y7;y3?777 3 ldenttficaflonofBouroe_,-__y___________^_Y/7;;-*fe^;^7273^2BiOM33^ i IB'I -^CA.0H.'81?;,i,7Ybia3^^^ ? fe-# I sagWiological analysis I '"i 7-77-'7-Y;', ' ORGANIC POTABLE ANALYSIS ’ OROXNl7iWNKnAicEZ^Lm iit^^ |-8ColifoiTnP/A{Public supplies) , __„1Walomethanes (524)7 _4i^latile Halocarbons (524) •±«aS9y»« 7 _ AmMaMiyknlMbieaM) 1 g ^'Cjdlterm MPN (prlv wail, raw, stp) _,^afile Aromfics (524) I '(^iF^’ Odlfwm (an samples) __ Total Trihalomethane Potential (510) 7'. __ Mlcroextractablas (504) . 77 ^^.Macroscopic _ Pestlcides/PCB screen (508) .2 Herbicides (SM18/6630,8151) •4^

yes no _ PCB as Decachloroblphenyi (508A) _ H©rbiddes (515) ~SSamXScides{531) : ■ ' _ Other.Pesticides (SM1W8630) '

_ Glycols In Water _ Add Bxtractebles' (626/8270) 5 __ Glyph08ate (547) ™„-W^____rng/L yes no __Diquat (549) , 8 7. _Chlorinatlon Disinfection Byproducts (551) J^C/MS Unknown Scan __ Phthalates (606MS) ’ ■

_______mg/L _;.Haloace8c Adds (552) " '■■ ............................................................................................................. '’■■■ ' Other_l_LJ».ZtxXJj--^^ _ other Pesticides (SM18/6630) _L)CMRLlst1 33"‘-7 78/8 <'77

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^3^7\.. ~ .IMtfee Only (524) .•A». ■A .7i7787S3W #3; 777 -7. .>3'-. i /..^Turbidity W7-sk > f’-.-v rKh/»..,4i«»„ ■ » - - _ Alkalinity _ Bromide • _ Bromate/Chiorate/Chlorite -/<rsenic Z^arium ^1^7'77 tothum >■ 3 7s; :

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VIh (5 day) zaaswsiss?!?’- zS£;S?^ 'i W':"-' I I ■H ^^WP&57 '1^!^ _ Nitrogen. Total iqeldahi as N, _*ebbaft „ Oil and Grease > ' it

■’1 Phenbl;7!73 / ; __ Phosphoru8 Total as P- ,, Total Dissolved ; _ Phosphorus. Ortho as P _ Sulfates Z-WiSslum .j^hgahesS ’ ' 3-:' -tcu^ I i^''

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