Chain of Custody Record, Westchester County Lab, Mar 2002

NYC 9/11 Public Portal Document ■"- '■/Y '

ENVIRONMENTAL SERVICES SAMl^UE SUBMmSlOH FORM WESTCHESTER COUNTY LABORATORIES ANO RESEARCH 2 Dana Road, Valhalla, New York 10595 I . (914)593-5576 NYS-ei^PNo.10108 Tlme/Date Set:

Sample Type (circle one): ‘

j J /^Potable V ^Non Potable 3. Non Potable Treated 4. Other ____________ IXifeX^O -no > Time/Date Coilactod: / , < f.-,. • V rp/.-/Z Comments: ! " c«aectedBy; H ., , Agency Code: _____ Collected From: LocgriiOn’anndlviduaFs Name NanwA3ompany Street Cltv/St/2ip ..... ' Identification of Souree' ., _ . ,.. , __piOTfe'^i~Z~TT2;^^ 9 ?

BACTERIOLOQICALANALYSIS ORGANIC POTABLE ANALYSIB

b' {circle tests) - I.Reterotrophic Plate {circtetests) 1. TrihalomeUianes (684) . ' ^|||waafltea^aa <' 1 qount {hernodiaiy8ls& all others) ■-. *^18. J t 2. Coiitorm P/A {public supplies) 3. Volatne Aromatics (584) 4. Total Trihalomethane Potential (510) 3. Acr^eln 4. Rth^ 3. Coli{ormMPN {privweB.raw. stp) Ys<j,'. 4. F6cal Coilform (aB samples) S. MIcroextracitebles (504) ’®^*otd^^(^)8/SO8 W*, lyHMy

I ^r' Refrigerated?yas __ iw 11. 1 r*j

Rrea Chlorine Res:____ 13. Diqyat (549) 14. Chtorinaacn Oisirriection Byproducts (551) . 13,^ 0^,-^^^^ wS^SSil r TWCWorineRes; ______ '"f /■/

fc: (clrciatasts) jCM«i«C AmvSISBEQWESTED

2. Twtttfity , ■■- .,22.,BromWe 23. Bromate/Chlorate/Chlorita p^um. I 4.Conducti\dty 5.Corrosivity(temp:______sC) >'•<'5 6. 8OO(5day) ■s'iWaS raSoiuhltW/^day) Total as CaCOa Y 9. Cartwnaceous BOD (5 day) Chemical Oxygen Demand 10. Dissolved O?^gen 29. NltrO^n,Nttrate as N si Il. Total Organic Carbon 1^/lbtafOr^M^ 13, Sol}ds, Percent (%) 30,.Mii^.MlAA3^.,v •.. SLNB^WMMlaeN 32. Oil an Grease Stopper r Ii 14.Soilds,S0tt!eable 33. Phenol 15.Solids,Suspended 34.Rwhorys-Wa9P ^^ad 'Y'- jfi- w 35. Phosphoru8. Ortho as P SCMagrteeium 16.Sol}ds,Total 17. Solids, Total Dissolved se.Sulfates ■ ira.TCUP'-HerWiSdes i 15. Solids, Total Volatile 37. Surfactants ^Werwry 1^Othw:_S!i________ 38. UV254 WMWS^

NYC-WTC_000074902