Chain of Custody Record, Sample AE06406, March 2002

NYC 9/11 Public Portal Document

ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORlES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 ,<>; pm. (914)231-1820 Fax (914) 2^-1772 3< I /«;■ h ■ ■ ;■ ■ •• ■ ■ 1" . , _ P^isSiSA^OoiOg^ Time/Date Set , y/ ^,./^:(r^;^l)i5 5 <

SampleType (clrcl9one); ' . ■■ Bottle rsY;:^yS^^,. W"' 7^^‘oteble , 3. Non Potable Treated ; 2. Non Pi^le 4. Other ________ Chain of Custody? Yes___ No -Tlme/batsCofle^^ ; ; I GdleetedBy: 1__ Agency Code: PWS #;Source ID: '____ ' Collected From: , ' BIK to: ' "’V ;;: y?/.... . 7' >: I- Locatlon’s/lndlvidual> Name /iyt/y 'ivJNaraelCpmpanY-JJ^JL^^

& fc. -x w ^^IttenWlrartkm Of _£^ -^YvWfaoneft Cltv/Stgip " .._ ,. -ygg

L -Collection Point

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Z. JW BAC^RJOLOQICAL ANALYSIS * _ Heterotrophic Plate Count _Trihalomethan8s (524) s > (hemodiali^s & alt others) Coliform P/A (Public supplies) _VolatileHalocarbons(524) __ Coltform MPN (privweli. raw, stp) _V(S)latlteAromatics(524) _ Total Trihalomethane Potential (510) I p ColHbim (all samples) _ Mlcroscoplc __ Mlcroextractables(504) {• __ Pesticldes/PCB scre8n(508) PCB as Decachtorobiphenyl (508A) r _ Herb!cid88 (515) __P8Stlcides (525) i; Refrigerated?__ _ yes —- to __ Oarbamate PesficideS (531) i_:,<3B^>o8afe^0 " e!M < yes„ no.. _ Chlorination Disinfection Byproducts (551) ' ■'fil^i^aiate^i TW Chlorine Res: ^ mg/L ^WateaCe«^>^/’(5S2r i/k4=— _Other Pesttddes (SM18/6630)" Y,;' ZiSZZZZIxZZZZZZ ’W ANAUmY'" W’ / \yy ? 4fc| iS&S 2==3^ . 4’'

M6R<SMfCANALYSISREQUESTED.t^<

I" eS/Tyibl<a^ --- ■ ¥ V-. ■, . ?; _ Alkalinity ’ ^LLBteffilCte H __Condoctrvity Bromate/Chlorate/Chlprite IB '4' —Chforide '3^^ I’ __ BOD (5 day) _ Cart)onac9ou8BOD (5 day) > Sa^. ■* '""S i* ‘ J iSis^ _ Soluble BOD (5 day) < ,_Cheml<ai! OxygehDemand ; _Dl8SolvedO)^n TotalOrganicCartion sK^iW Nitrogen. TotalKJeldahlas N I bBO “ 'T 8!%'^ T’,- ; I __TotatOrganteHai1des 'O-' ■ • .7'.. '

__ Oil and Grease S^- __ Sollds, Settleable .<' _ Phenol , , ’‘■ _ Phosphorus Total as P <^So!ld8,1btel : __ Phosphorus,Orthoas P „ Magnesium __Sollds.TotaIDissolved Sj: _ Surfactants __ UV254 ';.i^WWeinum' ...TCLP’-BNA’S 3 NYC-WTC_000075302