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Chain of Custody Record, Westchester County Lab, Mar 2002

Machine-extracted title · confidence 100%

Chain of custody documentation for environmental samples transferred to the Westchester County Department of Labs and Research in Valhalla.

NYC-WTC_000074851–000074856

Folder label: “AE 05235

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NYC 9/11 Public Portal Document Westchester ov.com ENVIRONMENTAL SERVICES SÄMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 231-1620 Fax (914) 231-1772 12 Time/Date Set: ED 1H ACCORD nela NYS-ELAP No. 10108 Form A-70 (rev.10/01) Sample Type (circle one): 1. Potable 3. Non Potable Treated (2.Non Potable 4. Other Time/Date Collected: 3/3/0z Collected By: :(lh) Agéncy Code: NEWE Collected From: Location's/Individual's Name Field Bank Street City/St/Zip Identification of Source Collection Point FBW Bottle #s: 2379,Q2251 Chain of Custody? - Yes_ No Comments: PWS#:_ Source ID: Blll to: Name/Company Street City/St/Zip Phone#: Fax#: Type Descriptor: CA,CH, BI? Check#: Amount$. BACTERIOLOGICAL ANALYSIS Lab#: . Heterotrophic Plate Count (hemodialysis & all others) Coliform P/A (Public supplies) Coliform MPN (priv well, raw, stp) Fecal Coliform (all samples) Microscopic Macroscopic APL: Other: Refrigerated? _ yes Chlorinated:?- _ yes Free Chlorine Res: Total Chlorine Res: _ по _ nо mg/L _ mg/L pH Lab#: ORGANIC POTABLE ANALYSIS _Trihalomethanes (524) - Volatile Halocarbons (524) - Volatile Aromatics (524) _ Total Trihalomethane Potential (510) Microextractables (504) Pesticides/PCB screen (508) PCB as Decachlorobipheny! (508A) _ Herbicides (515) Pesticides (525) Carbamate Pesticides (531) Glyphosate (547) Diquat (549) _Chlorination Disinfection Byproducts (551) Haloacetic Acids (552) Other Pesticides (SM18/6630) UCMR List 1 — MtBE Only (524) ORGANIC NONPOTABLE/SOLID ANALYSIS Purgeable Halocarbons (624/8260) Purgeable Aromatics (624/8260) Acrolein & Acrylonitrile (8260) Organochlorine Pesticides (608/8081) PCB's (Arochlors) (608/8081) Herbicides (SM18/6630,8151): Other Pesticides (SM18/6630) Petroleum Hydrocarbon Scan (310-13) Glycols in Water Acid Extractables (625/8270) Base Neutral Extractables (625/8270) -GC/MS Unknown Scan Phthalates (606MS) Other: RADIOCHEMICAL ANALYSIS Radon Other INORGANIC ANALYSIS REQUESTED - Lab#: → Color : Turbidity pH Conductivity Corrosivity (temp: °C) BOD (5 day) Carbonaceous BOD (5 day) Soluble BOD (5 day) : Chemical Oxygen Demand Dissolved Oxygen Total Organic Carbon Total Organic Halides Sollds, Percent (%) Solids, Settleable Solids, Suspended Solids, Total Solids, Total Dissolved Solids, Total Volatile Other: Acidity Alkalinity Bromide Bromate/Chiorate/Chiorite Chloride Cyanide Fluoride Hardness, Total as CaCO3 Nitrogen, Ammonia as N Nitrogen, Nitrate as N Nitrogen, Nitrite as N Nitrogen, Total Kjeldahl as N Oil and Grease Phenol Phosphorus Total as P Phosphorus, Ortho as P Sulfates Surfactants UV254 Aluminum Antimony Arsenic Barium Beryllium Boron :: Cadmium Calcium, as CaCO3 Calcium, Ca+2 Chromium, Total Chromium, Hexavalent Cobalt Copper Iron Lead Magnesium Manganese Mercury Molybdenum Nickel • Potassium Selenium - Silver Sodium • Thallium Vanadium Zinc CLP _Metals/CN Volatiles _ Semi-violatiles —Pesticides/PCB's ICLP TCLP-Metals —TCLP-Pesticides TCLP-Herbicides TCLP-Volatiles TCLP-BNAS NYC-WTC_000074856

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NYC-WTC_000074856Source: NYC Law Department, mirrored locally

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