Chain of Custody Record, Sample AE06333, March 2002

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBWIS^^F^bi^fti ' “'^... ....' R * - w,| S2Ea= aScw wioftjiWi^caiihY ^'11 ' 2 Dana Road, Valhalla, New York 40^ ;'|S? < (914)231-1620 Fax(914)231-17;^ - Time/Date Set: •-A'

|/ ' Sample iype (circle one); Jl^Potable 3. Non Potable Treated ■ ' BpMe 2. Noh Potable 4; Other ____^____j_________^_. Chain of Custody? -X Tbs___ No ri’

I <Tlnte/b^;e^lected: Conned By: tziiXXxM- Agency Code: ______ PWS #:________ X Source ID; ____Type Descrlptorr___ l’

r Collect^From; r • 'y Y Locatk^‘artndlvldual'8 Narne _________________ Name/Comoanv 'ffl ' ■ : _____________ '. ^^'^Street'___;________________- -■Sifeet'__XXXOSS3^^ Cfty^p \ '' ;CltyZStZZIpXXjOSSXWi|®i®ffi50~X' Identification of Source _____________ ' ' ''-Y^ .' Phone#: _____XXXX4X Collection Point ----- -----

f BACTERIOLOGICAL ANALYSIS Lab#:____________ ;__________ 1; 3^i^‘^XXXLXLY_>--Z-XL _ Heterotrophic Plate Count ORGANIC POTABLE ANALYSIS £. Trihafomathanes (624) ■ (hemociialysis & all others) I > _ Coltform P/A (Public supplies) _ Volatile Halocarbons (624) YL Ccrfllt^ MPN (priv well, raw, stp) Vblble Aromattcs (524) ; _J Fecal Conform (all samples) . __ Total Trihaiomethane Potential (510) __ Microextractables (504) __ Macroscopic; _Pesticides/PCB screen (508) X^X..-?Y.Y _ PCB as Decachlorobiphenyl (508A) ■X.’. ;Otf^. Y■ - ’" ' •. .u H^tcktes (515) / i _ Pestlcldes{525) ;L_iCa»fe8imafe;P^fld<te8 :t531^ 'r ;ye8_.^no_-x __Glyphosate (547)" j; : ---■' ' feSSSf^ ■" - ;;i..y3idUak{64fcifeSLr—;i^S^ ............... ... TfeeChIorlneHes:______ mg/T Res: _____ mg/L _ Chlorinatlon Disinfection Byproducts (551) /

__ Other Pesticides (SM18/6630) a _ucMRiJsti „MtBE Only (524) Z2Z2£ZZ2ZZ2inZ2 ■'^1 ; RADIOCHEMICAL ANALYSIS —Radon _______________________

y '< YT ■ r .^-erdmlde:-//-/■-'Y/</, feY'' - i _ Conductivity _ Bromate/Chlorate/Chlorite j^Wrfum L i_S bn ‘ Corrosivity (temp :_^«’C) _ Corroslvity _ Chloride .^erytlium _ BOD (5 day) _ Carbonaceous BOD (5 day) z» <zJa. 3 __ Solubl0 BOD (5 day) __,Ch0mlcalOxyg8nD8mand

_TotalOrganlcCarbon _ Hardness. Totalas CaCOa V _ Nitrogen, AmmonIa'a8 N _ Nitrogen, Nitrate as N ^ Nitrogen, Nitrite as N ' ;<

_ Ci TtSvalent- ^ r, Yt- '-S^^Tr^nnuM ■ y. ? ,'■ J Y / Total O^nic Halides _YWragen. Wl igeld^las N 'W.' » ’ * _ Solids, PeFC8nt (%) asS^SwYSx Sollds.Settieable ;? < „SQlids.Su8p8nded _Solid8, Total „Sonds, -tetel Dissolved __^Solids, Total Volatile /• _ Phenol Y..-_Pho8phorusTotalasP x _ Phosphorus, Ortho as P r'.,:_-.?$utfetes^’'r' -^.Surfactants y■ 3^

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