Chain of Custody Record, Westchester County Lab, Mar 2002

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FOR Dv.com WESTCHESTER COUNTY LABORATORIES ANO RESEM 2 Dana Road, Valhalla. New York 10595 " (914)231-1620 Fax (914) 231-1772

Tlme/Date Set:

^mple Type (drde (me): Quotable 3. Non Potable Treated Bottle #'s:

I' 2. Non Potable 4. Oth^ . / Chain of CustcKly? Yes.__.No Time/Date Collected^x_^^J^ Comments: ___ Collected By: Agency Code; PWS#: Source ID: .Type Descriptor. 1 Ir.. Collected From: BIH to:

I li Locatlon’s/individuars Name Name/Company_ Street ___________ Street City/St/Zip City/St«p___ -2Oi2L__-—-__aJ I' 'identification of Source Collection Point PhOnefe J

I CA.CH, Bl?. -. Check#: ___ Amounts________ ■ - -

! B/MTTERIOLOGICAL ANALYSIS Lab#:________________ ________ ___ ' 'V’ Lab#; ________ ORGANIC POTABLE ANALYSIS _ Heterotrophio Plate Count _Trihalornethanes (524) (hemodialysis & all others) __Coliform P/A (PubBc supplies) _ Volatile Halocartjons (524) i., ru^ieabte Arpm0tfcs T®44/828O) j JU Conform MPN (priv well, raw, stp) _ Volatile Aromatics (524) „ Fecal Coliform (an samples) _ Total Trihalomethane Potential (510) _ Microscopic _ Mlcroextractables (504) JalOwH MKvwWWfw _Pesticidesff»CB screen (508) z 4. ■ .1 _ PCB as Decachlorobiphenyl (508A) ._-'Other:____________ _ Herbicides (515) . _ Petroieurr> HydrocarbQn Scan (310-13) | _PestlcWesv(525) Re^erated? yes_j_no _ Carbamate Pesticides (531) tCi^nated:? _ Glyphosate (547) — yes -fto _Diquat (549) FreeChlorine Ftes:. _rng/L __ Chlorination Disinfection Byproducts (551) _rng/L I TotolChiorine Res: _ Haioacatic Adds (552) - _ Othen__i__„—__________ — r _ Other Pesticides (SM18/6630) _UCMRLfet1 RADIOCHEMICAL ANALYSIS _MtBE Only(524) ft ii.-.

INORGANIC ANALYSIS REQUESTED - Lab#:

E — Color _:Turbldlty Conductivity C-^iCorroblvIty (temp:°C) JU? BCD (5 day) __ Alkalinity _Bromtoa __ Bromate/Chlorate/Chlorite _ Chloride ^iCyanWe V^urhlnum

l^lfium <?- il fl Carbcmaceous BOD (5 day) Fluoride _Cadmiuin _ SolybleBOD (5day) _ Hardness. Total as CaCOsi ?^.J.CaWumi^ss CaCO^ .i- Chemical Oxygen Demand _. Nitrogen, Ammonia as N t s • Cafcitim.-Ca«/'7; ■ I __Dlssofved O)^gen __ Nitrogen, Nitrate as N Zlehromtum. Total , J 7 t —■•TWal Organic Carbon _ Total Organic Halides _ SoHds, Percent (%) _Solld8.Settleable __ Nltrogen.NltriteasN Nitrogen. Total l^eldahl as N „ Oil and Grease _ Phenol _^^CTramlum, Hexavalent „ Semi-violatiles

''YS' i Xrt. V*M /W<I IW U wb w __ Phosphorus Total as P _TCLP-Metals j- Wi I Z^SoBds. Total Phosphorus, Ortho as P ^tcijM»es8ci<fe8 .<s f ii:; 8dMA Total Dissolved _ Sulfates _ Spllds. Tota^laWe __ Surfactants :_:TCLP4ierfcfckte8 ■M*' _TCLP-Volatlles ^IfXwwr;:.. ______ _ UV254 JafPilckst _TClP-BNAs

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