Chain of custody record, Westchester County Department of Labs &

NYC 9/11 Public Portal Document

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; Tln^DateSet: s-;aagYY ■■ X- i^l^te'Typ®(circle one):. X Y'j X'X<Non Pota^'7^<i^i;5; /Oon Potable 4. 0ther xXXXX^

^"7 ^me/Date Collected: _2YU__ J^abfev Code: WCXlft,; SPW^.#: X-XXXX^sW^'t& I ff?-- Locatlon's/lndivldual'8Name XXt YYfcaMte SxX_X_ si«i_xxXxX2X^^^a x|SX-—._X_ il Clty/Stzap ■ , ,5 • \ ‘ ’ Y, X ft W ‘ of Source XWy; X-. '" Phone#: Collectionpoint X^XXX-X CA.CH, Bl? Check#:

BACTERIOLOGICAL ANALYSIS 4? ■ <■ Vft :l^b#: ._X2xXXX-XXX' X rteterotrdphlc Plate Count a < ;(hemodialysisSail others) : _CollformP/A(Public supplies) ; ORGANIC POTABLE ANAL^IS' ’ XTribalomethanes (524) X VdIatiie Halocarbons (524) X Volatile Aromatics (524) : ORGANIC NONPOTABLE/)SOL|D ANAt||l I X Collfbrm MPN. (priv well, raw, stp) ; X' Organochlorine Pesticide. {6O8/8O81};|<,5 | ■S X Fecal Coliform (all samples) a _Tota! Trihalomethane Potential (510) XMteroscoplc ' Y __Microextractabl8S (5Q4) ^Pestlcidesff’CB screen (508) X' Hert#ld^(SMl8/66^i8Ji^fe||^M I _ Macroscopic XAPiX'X--' -<Y' X PCB as Decachlorobiphenyl (508A) ■X Other Pesticides '(SM18/66^S$Wft I X Herbicides (515) _ Petroleum Hydrocarbon Scan (3lCh13)XX | 'X :Othen _i^XX_XXXX' i Si: Y-v':-' ■', Yf' ■■••

/Heftlgerat^?.X_yes^X no':' • ■ • •• X ^cWes (525) Y-- ■ . __ •';

XGarbamate Pesticides (531) 'Y _ Glyphosate (547) X-W^B(fractaio|ee/(82^7Q)X'f(t« | Chiorinated:? yes X_ no X -Base Neutral Extractables(62^8270)5X'l I X Diquat (549) , X'GC/MS Unknown ScartY I ;F^ Chlorine Res:_____ mg/L X^hlorination Dlsinfecfion Byproducts (551) ^tel Chlorine fte8: XXXY rngA. ; XHaloacetlc Acids (552) Xpther Pesticides (SMI8/6630) ' ■ -Y ' ^'•'xx~x2yxSSS^0S I Zlxzx—XX___ XUCMRListI fc Y fadiochemical analysis Only (524) SY /:ZXXXS5^Sl XRadon , Xx_XXx2x2X^^^^^^^^^^ 3 X-OtherXXX-XX-i_XX' ■ •,'. / ' ' / ;i ■ ■V'

<li<ORGANIC ANALYSIS REQUESTED-tab#: _____ 5 5'.-YX’Mfc^R5XXiXWt I i ^•PHY Color ' L^,:TurbidIfy < _ Acidity ................ _ .Aluminum >XAntimoiniy: . ‘t X , ' „Arsenlc fi? Conojctiylty '; .Brarnate/Chlorate/Chlorite Y';_Barlum y:) '''oY' - __Sodium _ Corroslvity (temp; °C) XBeryllium 5 l;;’S6p{5diay) __G^anlde .XBoron?-’^' TY’ __ Vanadium j ^ Carbonaceous BOD (5 day) .-■/X/iBi^e _Cadmium .^ Soluble BOD,(Sday) : .5iXW®*>«.-TQtti«'CabOs __Calclurn, a8 CaCCh : ■-'3 YY<Ya-^ I 'BY Chemtcal Oxygen Demand _ Nitrogen, Ammonia as N '■X Caldum,; Ca^ "Y •■' Xi Dissolved Ox^en ; __ Total Organic Carbon Nitrate as N X Ni^n. Nitrite as N ; XGhromloin,5lb1^' zSX“ ft X Total Organic Halides _ Chromium, Heravalent X Nitron, TotalKjeldah! as N X<Jobalt„Y;.;,,-X ■ X __ Semi-vlolatiles _Pestlc!des/PCB's ' ■ g YJ ; X Solids, Percent (%) "XW^Qrease' ■ .XCdpperY.'; ;Y5( ■/’A •■■' ■■pft--'’''.;’’ft '7-'‘ X Solids^ Settleable ■3X‘W^. >:•" '' 15 X Solids, Suspended /X Solids, Tbtat >, __PhosphoriisTotal as P _ Phosphorus, Ortho as P .4_lron;,;' __ Lead'<'Y; XMagiie^urn -aY,..-.

X <■: .jCLE/YYXH'YY/AYWS _YrCLP-Metel8 ;X I

X Solids, Total Dissolved ■-'X^6tetS» - , Y - ' __TCLP-Pesticid8S • ■ . ;• X. Manganese Y U —TCLP-Hertrfddes -'• W S X^Solids, IbtaiViDlatlle XSurfactants __ Mercury ft __Other: X_>X.^__ XMolyWenum 5 < Y^ , XTCLP-Vblatlle8''.'<a;*^ | _Tcip««s :i.Y B '.,__Nlcltel-X-'YX' . YaX

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