Chain of Custody Record, Sample AE06054, March 2002

NYC 9/11 Public Portal Document

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I k; Sample' (Gircle one): 3. Non Potable Treated BOW. I iPotableI 4. Other Y. of custody? Time/Date CdO^tiBA- _ . 'Comments:

I? I Collected- CollectedProm: Locatlon’s/lndivlduai’s Sterne 'y'P ’Agency.Code: _

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I _ Ctty/St/Zip___ 3_— s tderitiflcation of Source _ __________ . . ■ Collection Point 4T ________ _ _ Phone#:

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I bacteriological analysis Lab#:

Ift: ORGANIC POTABLE ANALYSIS YQ^SAMC'NiQil^CMG^^ ■^Heterotrophic Plate Count _Trihalomathanes (524) . - (hemodialysis & ait others) Purgeable Halocarbpns (824/8280)' J^CollformP/A (Public supplies) j^rVolatiie Halocarbons (524) . _ Purgeabie Aromatics (624/8260) - i / -Coliform MPN (priv well, raw, stp) .Volatile Aromatics (524) _ Acrolein & Acrylonitrile (8260) ? \Y Pedal Coliform (all samples) __ Total Trihalomethane Potential (510) - drganochlorine Peatidded (608/8081)' ’ « / Microscopic _ Microextractables (504) 4. pc8«w»ochte8KeiiM08i) • — W^rsMiaaem^D sf -.a Ig Macroscopic

_X:Other __ Pesticldes/PCB screeri (508) __ PCB as Decachlorobiphenyl (508A) _ Herbicides (515) _ Pesticides (525) _ other pesticides (SM18/6830) . iCY _ Petroleum Hydrocarbon Scan (310-13) _ Glycols In Water • ' I Refrigerated?___ , yes __ no _ Carbamate Pesticides (531) < . X ■ Acfo ExtrWabte8?(^28(82^)MWv:Ki<^

I Chlorinated:?__ _yes no FreeChlorine Res: mg/L _ Glyphosate (547) _Diquat (549) „ Chlorination Disinfection Byproducts (551) .Y Ba8e;NeutrafExtractaWe8 (625/8270) . _i/GC/MS Unknown :

f Total Chlorine Res: _____ mg/L _Haioacetlc Acids (552) __ Other Pesticides (SM18/6630) Phtfaiates

iv __UCMRLIst1 RADIOCHEMICAL ANAIYSIS _MtBE Only (524)

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; INORGANIC ANALYSIS REQUESTED . Lab#: Color ;■ _ Acidity _^Alumlnum ^.■pQta^h^5*f^^» I ^Turbidity _Alkalinity jfAntimony _ Bromide ■ jis^nic-' __Conductivity __ Bromate/Chlorate/Chlorite f ^^^ Corroslvlty (temp:'>C) _ Chloride LJsdSarlum □adBerylllum I ■;XSBOD(5day) ii-I; Carbonaceous BOD (5 day) _ Cyanide _ _Fiuorlde' \__B^n _>©adrnium , ;/sWS:'AsYaOi I _ SolublaBOD (5 day) U- Chemicat Oxy^n Demand __ Hardness, Total as CaCOs _ Nitrogen, Ammonia as N ;_ Calcium, asCaCOs i_.CateiiBn, Ca« ■; CLE _ Dissolved 0>^gen _ Nitrogen, Nitrate as N _^hromium, Total rCSS?*. I __ Total Organic Carbon Tbtal Otgahic Halides ' Y-L Solids* Percent (%) -X^/^lids/Wtleable _ Nitrogen. Nitrite as N __ Chromium, Hexavalent . _ Nitrogen, Total Kjeldahl as N _±Cobalt . _ Oil and Grease _ Phenol “Copper _^ron /Y _Seml-vlolattles l'P _Pe^cldea/PCB’8 >^1;^ ,

Ll Sollda, Suspended _ _Phosphorus Total as P -^tead Y <_ Sollds.lbtal __ Phosphorus, Ortho as P __ Magnesium Solids, -fotal Dissolved _ Sulfates □rlHanganese _TCLP-Pe8tlcteas ’..J _TCLP-HerblGldes 1 Yj; Solids, Total Volatile Other: 5^ __ Surfactants j-rMarcury __ UV254 _*!-Molybd8num

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