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Document / 4 pages

Chain of custody record, Westchester County Department of Labs &

Machine-extracted title · confidence 95%

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

NYC-WTC_000075123–000075126

Folder label: “AE 05965

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Scanned page image, NYC-WTC_000075126
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

8'7' 35;?B5Ti ENVIRONMENTAL SlujSk. SERVICES SAMPLE SUBMISSION FOllM

3: ■-^■-,'=2 Dans, VdfhSiJd* NiSW YC^C: jOoSSi,. Y (914)231-I8ib Pax{914)^3lJl772'; 11 I ■'> • 7l7NYBMA{»T^k^ 7:77Fotfa Ar^ (re^C^j. 7 '''X ‘ ' "" '•..•’s’

> -'ll"-'""' V Potable 3. Non Potable Traafed 1-7 _ Chain of Custody? X-Yes-__ No '

fe Bp . PWS #;Source ID: UXu-iype Descriptor Jx.

t ^'-,f^me^D<^pany.X±X«JLX7X£Xyi^ ———-x_

I -idSiwep______ —,_____ L_________ x ,, .7 7 .dty/SVZip .iLxXX-jOMOS--^^r-^0^^ .;lderw«i-ofsource_£ -------------- B 1‘CollectionPoint_________________ ■ ' ' ■ --------------i. _ ' ‘"f^one^XxX-XxXSIXXF^d!^ Ji.

»?5 j_rXX2x_____________ ' '77 •' ” I CA,CH, BI? .Ch^ XxiX- /^ntSUxSx; bXctef66l6gic/u. analysis t i it ORGANIC POTABLE ANALYSIS __Trihalomethanes (524); 'iifVofaHie Halocarbons (524) II iLi VPiatlle Aromafics (524} ; ; i :Xf^^^oOWT^W^sainpied) X'l iiifcfel Trihalomethane pots^sU (SiO) __Microextractabl88 (504) 7 „ Pesticides/PCB screen (508) * Heiblddes (SM18/6630 8151) I API - X PCS as Decachiorobiphenyl (508A) X Other 'J___ XHerbIcldes (515) __ Pesticides (525) yj. Refrigerated?___ yes___ no __ Carbamate Pesticides (531) Chlorin^:?___ yes___ no _Glyphosate(547) XtMquiat (549) XGC/MS Unknown Scan > V ’ Free Chlorine Res:_______ mg/L X. Chlorination Disinfection Byproducts (651) X Pb1Mla^ (®06MS) Total Chlorine Res:mg/L X HafeacetIc Adds (652) X,.6ttfetf2XxXXil^2SXiX^S X PH.; ■ XC«h^ Peteles (SM18«630) ‘ __________ 3^^XX_Xx . ••5 XUCMRListT " ' ' '.. ' " X . ''nW‘ ;■ ^R^^HE«KAL ANALYSIS ^MtBE Only (524) I i52x23wEiS^BS ft 3?B?W=55=5==a^—------------------------------------ 1 -fe' INORGANIC ANALYSIS REQUESTED - tab#: X'33 I _. Coior __ Acidity "yX ^l7/--i 7:;XAlkalinity- , _ Aluminum __ Antimony . - __Wdniufa-'7 Xi irf4YY7''7 ''7\-;__Bromidei .:_jfesenlc ■<.stiver , — Bromate/Chlorate/Chlorlte _ Barium, 7 X-Corros|vity (temp:____‘’C)' F *X'’eop(«W)7.?:;'X X Carbonaceous BOD (5 day) X- Soluble BOD (5 day): X ChemIcd Oxygen Demand ; __ Chlorid8

";_,Ru««1tlev; Hardness, Total as CaCOs _ _Nitrogen, Ammonla as N _i.Bet^llum __ Boron' ___Cadmlum i; 7 _ Calcium, as CaCOs __ Calcium, Ca«:, „Vanadiam

•^Metals^JN X _Disso1v8d Oxygen __ Nltrogen, Nitrate as N _Chromium.Totar. Total Organic Carbon „ Volatiles ; _ Nfax^en, Nitrite as N __ Chromium, Hexavalent __ Seml-violatiles 1 X:/WOroanicH^^ __ Nitrogen^ Total Kjeldahl as N .XCobalt.-.. __ Sollds, Perc8nt {%) ' ? „Pesticid8s/PGB’s OU and Grease ^Copper : 7X7M<l8/Sottleable ■ ■ _ Phenol' ;_ Iron'.. 7 X Solids, Suspended __ Phosphorus Total as P. _Lead ’ _ So!lds, Total „TCLP-Metals __ Phosphorus, Orthoas P __ Magnesium _TCLP-Pesticides : X Solids. Total Dissolved __ Sulfates . __ Manganese .• ; X. Solids* Tbtei Volatile __TCLP-Herbicides _ Surfactants __ Mercury X-jnOLP^felatiles? •‘ Other: _________ _ UV254 „ Molypdenum i <;■ ■■■,i- Nickel ; ,XLi_';LL-.r.Aife NYC-\/VTC_000075126

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NYC-WTC_000075126Source: NYC Law Department, mirrored locally

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NYC-WTC_000074314 · Box DEP Box 62

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

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