Chain of Custody Record, Westchester County Lab, Mar 2002

NYC 9/11 Public Portal Document •Tyr

h I’ Time/Date Set: ^com ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABOR^RIES AND RESEARCH 2 Dana Road, Valhalla. New York 10595 (914)231-1620 Fax(914)231-1772 .jz

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Sample Type (drcleone): i IJ’otable 3. Non Potable Treated Bottle #*8: T Non Potable 4. Other „ > y _ __ .- ■ Chain of Custody?^—*.

ifeiemale'Oojy y . Comments: - ..'-- ■• ■ --/ZY----Y--"- J Collected By: ___ ,, \PWS_#:-_z—Source ID:y:y Deswiptor__ j Collected From: .’W0: ’"y? ■ -yY YJ i^cte’^lndiylduara Name ; Natne/Cotnpaily YY/ X- street 't; Street _ K's' ■ r^/swap ■ City/Stfap, I'’.

i identiflcation of Source Phone#: Fax#: - y-y. Yyy Collection Point ————— I CACH. Bl?--------- Check#: Amount$- ■’g-'AY " ■■

BACTERIOLOGICAL ANALYSIS lA" - . --.d-d Bl- ORGANIC POTABLE ANALYSIS > ORGANIC NONPOTABLE/SOLID ANALYSIS d J >■ dTHhaIbmethahes (524) PurgeableHa)bcarbbns (824^)) d (hemodialysis & all others) i__Colif6rm P/A(Publlc supplies) _ Volatile Halocarbons (524) . ^ Purgeabte Aromaffcs T624/8260) d - i -/ _:_Collform MW (priv wen, raw. stp) __ Volatile Aromatics (524) ■.,. . WOW\ ___Fecal Conform '(all samples) _TotalTrlhalomethanePotential (510) " __ Oigar^lorlnePesScides.(608/8081) yj . ’ 5-- __£Microscoplc ' _ Mlcroextractables (504) . ,. _Pestlcldes/PCBscreen(508) I K nfiCIwf waww|>/w _PCBaaDecachfotbblphenyl (508A) ' y .. i

teiB^_y«-Xno -__Carbarttbfo-Pe8tlcldes/(531):: | __ Glyphosate (547) 'd I yes___ no _ Diquat (549) _b<QC/MSUnknov^Scan '"Fi^'^Ji^ne Res:.;,,______ mg/L „Chlorinatlon Disinfection Byproducts (551) __ Pht)ialatss(606MS) , j

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:ALANALYStS __HaIoaceticAcids (552) — Other Pesticides (SM48/6630) -UCMRU^I ■ ^.wo-yy(524) f" ' ' 'Yyd ^ _''Otherzk—Zizzl—Z-Z—_X—

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' ' ' ;g||i^l^NiCAN^L^B REQUESTEpA^' i'' 1^'; d- Color - _A:ldity .VfAIuminum B' —.Turbidtty

__ Condudivtty —AIKaBnlty ? _ Bromide _Brornate/Chlorate/Chtorite ' / iVBari Arsenic • iSS5?”l ayg * -"YagfeiolajC ' -T| __ Corrosivity (temp:___.'’C) _ Chloride y? /^fiehrtHunt' K' __ BOD(5day) —; Carbonaceous BOD (5 day) —Cyanide Fluoride < —Cadmium k." F "—Soluble BOD day) _ Hardness.Total as CaCOs Calcium, as CaCOa ■ «y- ‘a

I" iY Ghetnii^ Oxygen Demand „Di8solved Oxygen Nitrogen, Ammonia as N / _Y |flfto$b,;N»afeMN^ Caldum, Ca« ^Chromlum.Total i I/; Zz MefetS/CN -.yz 'J: _ Total Organic Carbon __ Nitrojpn, Nitrite as N __ .Chromlum, Hexavalent _TotalOrganlc Halides _ Nitrogen, Tolal Kjeldahl as N dSJCpbatt _Setni-vlolatUe8 ; _ SoBds, Perceht (%) —. OllMaOrea^ i&i’CSc^pef — Solids, Settleable — Phenol Jteflron __Sollds, Suspended _ Phosphorus Total as P j^Lead IfitE _TCtP-Metats <■ Solids. Total _ Solids. Total Dissolved __ Phosphorus, Ortho as P _ SuifetM _ Surfactants _ Magne8lum .^Manganese WC Mercury __TCLP-Pestfddes - __TCLP-Herblcldes ^w __TCLP-Volaffl88 ■>} _ UV254 JiiMolybdeTOjm MNlckel _TCLP-BNAs 1 feL— ■4

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