NYC 9/11 Public Portal Document
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ENVIRONMENTAL SERVICES SAMPLE SUBMISSION PCIRI^ Fo
v(X)m WESTCHESTER COUNTY LABORATORIES AND RESEARCH
2 Dana Road, Valhalla. New York 10595 •'
(914)231-1820 Fax (914) 231-1772
^S-ELAP NO. 16108 ■'
' Time/Date Set:
iS (drdeone):
</ 3. Non Potable Treated _'.J
2. Nori Potable
Tlme/Date Collected:
4. Other
/6
_ ChafnofCustody?_Ye8 ___ No, .
_ Com„.„«:____________ ;_________________ IMI,
Cpiledted By: "pi Aaencv Code: PWSft------------A Source ID: >
_Soun»ID:__Tvi»0«o;l'ptor4,r',';
■■3
■ .'“'I"- . . \
Locatlon's/lndlvlduarsName ■ _ Name/Company___________________ J_____ ' • /- J
S Street _ " ^Street |
City/St/Zlp_j6 _ City/St/Zlp S
-' 'Phone#: ' . . Fax#: ''
__Fax#: ' 'J
Identification of Source
Collection Point - ' ■ /A
CA,CH, Bl? Check#:Amount s
BACTERIOLOGICAL ANALYSIS Lab#:
V' Lab#: ______________
ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLIDANALYSIS |
Heterotrophic Plate Count __Trihalomethanes (524) _ Purgeable Halocarbdhs<:(624/^6Q);llfti P
(hemodialysis & all others)
__ Coliform P/A (Public supplies) .Volatile Halocarbons (524) Purgeable Aromatics X62^26(QS?/feS W g
_ Coliform MPN (priv well, raw, sip) bVolatile Aromatics (524) __ Acrpleln& Acrylonitrile (8260)
_ Fecal Coliform (all samples) _ Total Trihalomethane Potential (510) __ Organochlorine Pesticides (808/8081)
f. Y- Microscopic __ Microextractables (504) .iiY PCB's (Arochlors) (608/8(181) /
_ PestIcides/PCB screen (508) r
_ MaC3O8COfrfC .
— API __ PCB as Decachlorobiphenyl (508A) M other Pesticidee (SMI8/6630) ; . ’
_ Other: ■■.________ _ Herbicides (515) Pebpleui^ Hydrp^ (310-13)
__ Pesticides (^5) Glycols in Water
Refrigerated? yes no __ Carbamate Pesticides (531)* YC^/Ackt Ext^c^les (82a®^d)
CWorlnated:? __ yes___ no __ Glyphosate (547) M Base Neutral Extractables (625/8270)
_Diquat (549) :^^C/MS unknown Scan
Free Chlorine Res:______ mg/L __ Chlorination Disinfection Byproducts (551) Phthalates (606MS)
liotel Chlorine Ros: mg/L _ Haloac8tlc Acids (552) :cO»tfwirC^
pH—
/ RADKXHEMICAL ANALYSIS
Radon. ■
__ Other Pesticides (SM18/6630)
_UCMRList1
_MtBE Only (524)
s
— Other _ ________________ _
INORGANIC ANALYSIS REQUESTED - Lab#:
2ZZS7: 1
/—-.Color-.: A'. Acidity < ■ Auminum
Turbidity ^Akallnity :■ "Antimony
_ Potassium.
^.Selenium SSI
S,A.’W
--'.pH , __ Bromide ‘Arsenic \?^SilTOr
, _2_ Condyctivlty _ Bromate/Chlorate/Chlorite ..Z-irlum _XSodium
_ Corrosivity (temp: °C) _ Chloride _lBeryllium
__BOD(5day) _ Cyanide Boron '.'I. ?.
_ Carbonaceous BOD (5 day) _ Fluoride . , MOadmIum . SjSS'
S_;soiuble BOD (5 day) _ Hardness, Total as CaCOa _ ; Calcium, as C^Cps. f ’W
_ Chemical G^gen Demand _ Nitrogen, Ammonia as N HI3
_ Calciurn, Ca«a
_DissQlvedO)^gen _ Nitrogen, Nitrate as N J^phromium, TiaW- S : ' _Volatlies .
_ Total Organic Carbon
_ Total Organic Halides
_ Nitrogen, Nitrite as N
__ Nitrogen,, Total Kjeldahl as N
__ Chromium, Hexavalent /
^Cobalt
^Semi-violatiles
',I^Pesttc^f^8i>J/: 'I-.. I
I
_L Sollds, Percent (%) _ Oil end Grease popper
._i-‘Sollds, Settleable ’__ Phenol pron ;
_ Solids, Suspended _ Phosphorus Total as P ICLE :
.'.Meal'' ■i^TCLP-MdtalsA¥\v;'
— Solid8.;-tbtar; Phosphorus, Ortho as P _ Magnesium ; /
_TCLP-Pestlcldes
_ Solids. Tbfal Dissolved _ Sulfates YMManganese ;;
_TCLP-Herbicides '41
^llds. Total Volatile. _ Surfactants
XTCLP-Vblatiles
;.^UV25^>.^ Mdybdenum _ TCLP-BNA's ;;
.Nickel ’
iss
NYC-WTC_000075326
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