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 nester 2ov.com ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM 2 WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 231-1620 Fax (014) 231-1772 Time/Date Set: 37 AÇCO nelache NYS-ELẬP No. 10108 Form A-70 (rev.10/01) Sample Type (circle one): Polable 3. Non Potable Treated 2, Non Potable 4. Other — Time/Date Collected: 102 Collected By: Lab Agency Code: NL NC Collected From: Location's/Individual's Name F.eld Blank Street _ City/St/Zip Identification of Source Collection Point FBW Bottle #s: C1341, P 2123 Chain of Custody? _ Yes No Comments: PWS #:- Source ID: Type Descriptor: Blll to: Name/Company: Street City/St/Zip Phone#: Fax#: CA,CH, ВІ? Check#: Amounts. BACTERIOLOGICAL ANALYSIS Lab#: Heterotrophic Plate Count (hemodialysis & all others) Coliform P/A: (Public supplies) Collform MPN (priv well, raw, stp) Focal Coliform (all samples) Microscópio Macroscoplc: API3: 3'Other; Refrigerated? — yes — no Chforinated:? _ yes _no Free Chlorine Res:_ _mg/L Total Chlorine Res: _ -mg/L pH: RADIOCHEMICAL ANALYSIS Radon Other Lab#: ORGANIC POTABLE ANALESIS 4 _Trihalomethanes (524) Volatile Halocarbons (524) Volatile Aromatics (524) Total Trihalomethane Potential (510) Microextractables (504) _Pesticides/PCB screen (508) _ PCB as Decachlorobiphenyl (508A) Herbicides (515) Pesticides (525) Carbamate Pesticides (531) Glyphosate (547) Diquat (549) Chiorination 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 Extractabies (625/8270) 2GC/MS Unknowni Scan: Phthalates (606MS) _ Other: INORGANIC ANALYSIS REQUESTED - Lab#: Color Acidity Turbidity ph - _ Alkalinity Bromide _. Conductivity: * Bromate/Chiorate/Chiorite Corrosivity (temp °C) -Chłonde BOD (5 day) •Cyanide .:: Carbonaceous BOD (5 day) Fluoride Soluble BOD (5 day) -Hardness, Total as CaCO3 Chemical Oxygon Demand - Nitrogen, Ammonia as N Dissolved Oxygen ,Nitrogen, Nitrate as N Total Organic Carbon - Nitrogen, Nitrite as N Total Organic Halides ,Nitrogen, Total Kjeldahl as N L Solids, Percent (%) - Oil and Grease Solids, Settleable Phenol Sollds, Suspended Phosphorus Total as P Sollds, Total Phosphorus, Ortho as P Solids, Total Dissolved Sulfates Solids, Total Volatile Surfactants Other: _ UV254 Aluminum Antimony _ Arsenic Barium _ Beryllium Boron _Cadmium _ Calcium, as CaCOs _ Calclum, Ca* * -Chromium, Total _ Chromium, Hexavalent _Cobalt _Copper _ Iron Lead Magnesium _ Manganese Mercury .Molybdenum :Nickel, Zinc CLP ICLP -TCLP-Metals -TCLP-Pesticides -TCLP-Herbicides - TCLP-Volatiles TCLP-BNAS NYC-WTC_000074954

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NYC-WTC_000074954Source: NYC Law Department, mirrored locally

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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.

6 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.987