Chain of custody record, Westchester County Department of Labs &

NYC 9/11 Public Portal Document

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I'f Y' ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM ■: /■ /'.S DOm WESTCHESTER COUNTY LABORATORIES ANO KESEARCH . . I 2 Dana Road. Valhalla, New York 1050^??.>■/. 1/ 3 (914)231-1620 m(914)231-1772. .■<. v<:- Si'j>- ’;T« T. ‘ NYS^lAPNo; 10108 S?

A'” ColfectedSy: XJ3j3h23£3S_, Agency Code: PWS #: \ Source ID: PescrloteT^ -5 Locatlon’s/tndMdual’sName . >, . Name/Company________ _ ______________ _ ________3—.

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i ORGANIC POTABLE ANALYSIS '__ Heterotrophic Plate Count 8 .,-? (hemodialysis 8 all others):, - _TrlhaIomethanes {524); > ; _^Vol0tlla Halocarbons (524) ' „ Coliform P/A (Public supplies) 3 3i;VdWArothaflc8;{524) t,! Fecal (alleles) . i-Tbtal Trihalbmethane Potential (51 Oy g_L Microscopic, ■ ' Y „ Mlcr6extractable8 (504) _Pe8tlcldes/PC8 screen (508)

|r-wl£2_i_ .■ _ Herbicides ^(515)3-,3;/ ^TfReft^e,«ted7_ye8_no- .•3H^^’<525)''^"W■ __Carbamate Pesticides (631) : .:^^AeaWract0t^''^§^ Chlorinated:?___ yes___ no i ^MGIyphbsata (547) ,^ <3 Ba^eiuttW^tract^|e^<6^27Q)»k; I Free Chlorine Res:___ ___ mg/L ' ' >ijDJ^'W)S-;:; ............................e ±;.X5htor1naflOrt Disinfection Byproducts (551) 3. PhthalatBS {606MS) Total Chlorine Res:------------ rngflu __Haloac0tlc Aclds' (552)1/■ 0tiwi®3Z333XMZ3^^ P PH.__ . - __OtherPesticides (SM18/6630) ;■ .3_-!^MRLi8ti3;. Y.'- ■ ' 3 . Y „MtBEOnly(524) .r t/Won’xv; ■ g|^10BwkT?.</

j INORGANIC ANALYSIS REQUESTED - Lab#:. ■«

'•V _V^uminum ■ 3 '4 ■ Color __ Turbldity, _ Acidity 3_ Alkalinity/ -'Y 1 i^Srwiide/' 13; Conductivity^^ > _. Bromat0/Chiorate/Chlorit8 Corrosivity <t8rnp:.3_23C)^ ; _<Chlorlda ^sarjlliutn - A3;. 4^ ft- <3.. ,- 3i.Cdrt»nacepu8 SOD (5 day) Fiuoride —— ' ; : • y; ■ u I _cadroium ; 3 :;>inc (5 day) _ Hardness, Total as CaCOs __ Calcium, as CaCOs HI’S ChemIcal Oxygen Demand __ Nltrogen, Ammonia as N _ Calcium, Cb*« / _ DissolvedOxygen __ Nibo^n. Nitrate as N ij/Chromlum, Total _ Total Organic Carbon _ Volatlles f. tk', Nitrogen, Nitrite as N _Chromlum, Hexavalent _Semi-vlolati!e8 totej Organic Halides Solids, Percent {%) 3k Solids. SettJeable , .^ Nitrogen, Total Kjeldahl as N Oil and Grease _Cobalt _c6pper _Pestlclde8/PCB’s o « —. Solids, Suspended __ Pheriol /I __ Phosphorus Total as P _TCLP-Metal8 ii. Solids, Total : ; 7 3 _ Phosphorus, Ortho as P _ Magnesium . ' ; _ Solids. Total Dissolved „TCLP-Pestlcide8 _ Sulfates __TCLP.Herbicld8S __ Surfactants iry ■ . ; "V

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