Chain of Custody Record, Sample AE06301, March 2002

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM gaSgg^lmni WESTCHESTER COUNTY LABORATORIES ANO RESEARCH -■ WBwPwy/Y- ■ y"^DenefWr>^iHbn^:N<mfc .Y y /.Y;YY/yy(9i20»i62Q'hxm23i-Oy^s;:yyiW y . y/. I ' J2±S±_________ ______ • ... 1 Sample Type (circle one): >»i3ss^Yyi.^F^j^Yy// V ■ '^NonPd^ . ' /A other ;Chhihy.C^^^^^^^yNYYYyY|^^^^2 b ,■ yTirne/bate(^le^:2xS5L!^SS22X~yZZy^-T\CoinrrwMriU:lyY|^|?y|®^^ j

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' city/st£?in /Y7;iYy;;^y:VgysyyaYy^^^ I ; Identification of Source ; Phone#: y 5^'®°^°":P?lnt y Z^----------------- ----- —---- r CACH.Bt? . Check#: . Amounts \ >- y ' Y;_^_2^Y____;j_^^2y)_Y^.^YYuiyyYYY__^__yY_,___LyyL.^__y^_j_yy__Yyyy._YiYyYyyysysy2Y3yy4yss^^S bacteriological ANALYSIS ■Lai^: ._.._yy.yy.^^ tab#:_

ORGANIC POTASLE ANALYSIS yiiBy/yilil^^B! ;/rpRGX^ N^pOTiwsii/sdtJi^ _ Heterotrophic Plate Count : „TrihaIomethanes (524) (hemodialysis & alldthers) yi^oBform P/A (Public supplies) ^^Volatlla Halocarbons (524) ■ y_ Purgeabla Aromatics (624/8280) | _ Coltform MPN (priv well, raw, stp) .trVolatile Aromatics (524) Yy ; Acrolelri& Acrylonitrile (8260) '. .r , __ Fecal Coliform(all samples) _ Total Trihalomethane Potential (510) yi. Micrbscqcic < /Y'-' ■, "'./’'-y Y; Macroscopic y , -_^API..?;. /Y.- '</'-;Y''YY''/■/ -■ y £_ Microextractables (504) __Pesticides/PCB screen (508) _:^ PCB as Decachlorobiphenyl (508A) ylSSMOSTMl /.-.yy ^dth6f;p^tl<^5i<l^(^ I £<.pth6r; □yy.yXy-----^ _ Herbicides (515) Pesticides (525) ' --it— wypcMs,Hl^y.^ t .-• I Refrigerated? __y Yes _y_ no _Carbarnate Pesticides (531) ’ y B ■Ac^:©d»id^,5j62&^ I Chlorinated:?__yes__no .^ Glyphosate (547) y_ Base Neutral Extractables | ^.Diquat ,(549) - y.lYGCiMs .bnlmpwriScanyYY< Y-y^^«| Free Chlorine Res; mg/L ; __Chlorination Disinfection Byproducts (551) ’ >. Phthalates (606MS) y Y',z-»y.- Total Chlorine R^- y ■-. ' -mg/Ly yyHaloacetic Acids (552) '' 7 yy Otheryyyy^^ y_ Other Pesticides (SM18/6630) ■ B'-Y-y 7 YY 'y,ucMRListt"'yy'''''‘Y ■■..■yyYy-y-^'syyYTYO- RADIOCHEMICALANALYSIS ■yiMtBEOnly.(524) • Y Yj^' yyy;B'y"'yy"Y ."y'. .Radon Other hR INORGANIC ANALYSIS REQUESTED - Ub#: footer- .J. Acidity _Jj?Quminum vS > y _ Potassium' Turbidity ..y y ;Y

___ Conductivtty 'e-Y; t _ Corroslvity (temped y^Wkatlnity y■•-yy-Y-;' . _^reenlc y.; Bfoihate/Chlonate/Chloilte V Y:*Anflma»y 'Y ' Yi; _Jha|^'/ /^rSefertunt r ?C) _Chtoride y^BerylHum y yl _,,pop(5day) /' ;y.Cyari|de _Boron y .’Y ^. Carbonaceous BOD (5 day) -djSR* ‘ YYSduble BOD(5 day) J Chetnipal Oxygen Demand _y Fluoride Y Hardness, Total as CaCOs ■ yJOwMim' y Y. Calcium, as C^Os . .^sSissiyjssw Nlbpgen; Ammonia as N Calcium, Ca««Y _ Dissolved Oxygen y Tbtal Organic Carbon __ Total Organic Halldes _ Nitrogen, Nitrate as N yy. Nitrogen, Nitrite as N ; yj-ehromlurn, Total y_ Chromium, Hejfavalent Y' _ Nitrogen. Total l^eldahl as N _yCobaIt (. i Y. ^iids, Pemeht (%) __Pesticid9S/PCB's ' : yy Olf and Grease y yyjgCto^pSfyyy ' '.yy ;6-y Y. Solids. Settleable Y iron .is^yyyy Y''y '.Yyyji^ I _ Solids, Suspended „Phosphorus Totalas P ■ yuTOrR^M^ S Solids, TbtalT Y _ Phosphorus, Ortho as P .2. Magnesium _TCLlM?^cide6.YyW^I __ Sollds, Total Dissolved _ Sulfates . __^anganese _TCLP-Herblcides ; J _ Sdlids, Total Volatile _ Surfactants ■ >-«^Men^ry' _TCLP-\totetlles <VY:^ ^i^-Othen _ UV254 .jitfMPlyb^^

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