Chain of custody record, Westchester County Department of Labs &

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Form documenting the chain of custody for samples submitted to or received from the Westchester County laboratory.

NYC-WTC_000074949–000074954

Folder label: “AE 05696”

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NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSIONf FbRM ”•'^1 WESTCHESTER COUNTY LABORATORIES AND RESEARCH ;'W :com < M 2 Dana Road, Valhalla, New York 10595 1# (914)231-1620 Fax(914}'231-1772v , ..... , .. ; NYS-ELAPNo. ibit^ii^ FormAr70(rev.10/01),Yi^

I mMi.iyiw (cirdeone): 6’1170 fl-‘2.4M'It ./'T* '■ I '2i'Non Potable 3- Mon Pebble TZeated 4,0&ier_______ ____ ^i^teCollected;2i6^tUZ___ll£:£^ Boitie » Chain of Custody? ±_ YiB8:4^ No '’■ I Comments: [ 'Collected Bv: - Aoenev Code: PWS#: SourcelD: Type Descriptor

T .•" r'T-t,-; z. "‘'^-V^F^Cainps^ .^street Hp&ltaVXf Vriup _ -/Street ■■ -Y.,?. Y _ Clty/StglD ; /? i Identifidatidn of Source_____ _ _ Phone#:_ _____ Fax#: '{1

BSiWltlWJ,!#. CA.CH, Bl? Check#: Amourit$ — a " BACTigiibLOGICAL ANALYSIS Lab#:____________ :______ oiiGANld NONPOTABLE/SOLID ANALYSIS Is ORGANIC POTABLE ANALYSIS . __ Heterotrpphlc Plate Count _T)1halomethanes (524) _Purgeable Halocarbons<624/8260) others) £,^^latile Halocarbons (524) J J 2_. GOrm P/A/(Publlc supplies) __ Purgeable Aromatics (624/8260) - _-.; ee|lforrtt1VPN : (priv well, raw, j^oldtile Aromatics (524) Acrolein & Acrylonitrile (8260) ; i2^"F|;^l' b611forrri (all samples) _ Total Trihalomethane Potential (510) __ Organoch1orin8. Pestlcides (608/8081) _ Mlcroextractables (504) :.__ PCB’8 (Arochlors) (608«b81) " _ Pesticides/PCB%creen (508) _i Herblddes (SM18«63O,8151)\'. _PCB as Decachlorobiphenyl (508A) _J:Othor Pesticides (SM18/6630) _ Herbicides (515) __; Petroleum Hydrocarbon Scan (310-13) -------------- _ Po8ttcides (525) __6lyc618in Water Y Refr®^^? __ yes no __ Carbamate Pesticides (531) _ Add Extractables (625/8270)

I 'X_ yes X no Free Chlorine Res:__ _mg/L __ Glyphosate (547) _ra(}U^ (549) _ Chlorination Disinfection Byproducts (551) „ Base Neutral Extractables (625/8270) 7/bC/MSUnkndwn Scans , _ Phthalates (606MS) < I -------- _mg/L _Halbacette Adds (552) _■ Other.-- - : ■ .•■ Z-. ... < . _Other Pesticides (SM18/6630) __UCMRLlst1 HgljgggJCHEWCALANALYSIS _MtBE Only (524) «*•

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Y- i Wb^GANlC ANALYSIS REQUESTED - Lab#: Acldity ^{^umlnum lum

__Bromate/Chlorate/Chlorite Chloride; A jZ&riuim ji^iIlium fwP:

& __ Cyanide \LiWiadium .zz Carbonaceous BOD (5 day}; — im pg/Sblubl<8<5CL;(5d8^,Z;'<^/- ’tJhMiiiMl O)^en Demand Dissolved Oxygen zBxsaf Ci^Mm, as CaCOa _ Calcium, Ca*2 ,,^hrbmlum. Total ’ _JVIetal8/CN ? _ Volatiles , T3tai,OrgBic Carbon j.; :\; w /g2;Y^l brsanic Halides __Serhj-violatlles i©.'Solids, Percent (%) ■ -gfaast***”-’'. _ Pestlcldas/PCB’s ■<__Solids, Settleable /__ Solids, Suspended ' Phosphorus Total as P "g^ad. leu ,?^,^lid8,-total _ eh«<^Ortto».P Y ; __TCLP-Metal8 »;<Zg Solids, total Dissolved.;; ___TCLP-Pesticidas , Z SudaSnts Z^jteiry^® „tCLP-Herblclde8 ; JKienum' . ■ __TCLP-Volatlles ' Yfl

NYC-WTC_000074952

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Chain of Custody Record, Westchester County Lab, Feb 2002 · Box DEP Box 62

NYC-WTC_000074314

Documentation tracking the custody and transfer of environmental samples to the Westchester County Department of Labs and Research.

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