Chain of custody record, Sample AE06588, March 2002

NYC 9/11 Public Portal Document

iS ACCOa ENVIR ENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER HSJNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 (914) 231-1620 Fax (914) 231-1772 I I': NYS-ELAP No. 10108 Time/Date Set: FormA-70(rev.10/01)

Sample Type (circle one): I' i<Potable 53. Non Potable Treated Bottlers; ■'.. . ,.. ........ ,, v v ,:Yr/ 2.Non Potable J4. Other__________ Chain of Custody?___ Yes No Time/Date Collected: Comments: Collected By;..... . Agency Code; Source ID; Type Descriptor; ■f Collected From: SMte Location’s/lndivldual’s Name Name/Company Stre^.. j . . ... . .. Street............. I B^rBtgg .. City/St/Zip __ Identification ofSource Phone#; Fajcif: Collection Point . ........ ■ >4 Mem SIS •j Check#: M BACTERIOLOGICAL ANALYSIS >4- Lab#:_____________________ ORGANIC POTABLE ANALYSIS ORGANIC NONPOTABLE/SOLID ANALYSIS _ Heterotrophic Plate Count _ Coliform P/A (Public supplies) __ Coliform MPN (priv well, raw, stp) „i^V6latile Aromatics Acrolein & Acrylonitrile (8260) __ Fecal Coliform (all samples) _ Total Trihalomethane Potential (510) _ Organochlorine Pesticides (608/8081) *1 __ Microscopic _ Microextractables (604) _ PCB’s (Arochlors) (608/8081) Postida^PCBsetsen __ PCB as Decachlorofaiphenyl i^OS^ _ Herbicides (SM18/6630.8151) Other Pesticides t' _ API .... Other:.,,,...... ..... _ Petroleum Hydrocarbon Scan (310-13) _ Pesticides (526) __ Giycols in Water Refrigerated? ___ yes _ no _ Carbamate Pesticides (tel) _ Acid Extractables (625/8270) Chlorinated;? __yes_no _ Glyphosate (547) _ Base Neutral Extractables (625/8270) _is-GC/MS Unknown Scan Free Chlorine Res:______ _ .Chlorination Disinfection Byproducts (551) _ Phthalates (606MS) Fi Total Chlorine Res; ,,^mg/L Haloacetic Acids (552) _ Other:____________ Other Pesticides (SM18/6e30) UCMRListI .MtBE Only (524) _Radon Other ___________ _

INORGANIC ANALYSIS REQUESTED . Lab#; Jr Aluminum _f^sWum __ Turbidity _ Alkalinity _r^timony ■I --..PM „ Bromide _vrArsenic Conductivity _ Bromate/Chiorate/Chlorite ^.SddluB _ Corrosivity (temp:-------- „ Chloride _LiBeryltium _>.*-Thai!ium __BOD(5day) ___ Cyanide _ Boron _ Carbonaceous BOD (5 day) _ Fluoride >-'Z!nc Soluble BOD (5 day) _ Hardness, Total as CaCOs _ Calcium, as SW■ __ Chemical Oxygen Demand _ Nitrogen, Ammonia as N _ Calcium. Ca« ___ Dlsso^ed Oxygen Nitrogen, Nitrate as N _i.Chromlum, Total _Metale/CN __ Total Organic Carbon _ Volatiles _ Nitrogen, Nitrite as N _ Chromium. Hexavalent _ Total O^anicHalfoes _ Nitrogen, Total Kjeldahl as N _8emi-violatites _ Solids, Percent (%) __Pesticides/PCB’s _ Oil and Grease .^-Copper Solids. Settleable _ Phenol TCLP _ Solids. Suspended _ Phosphorus Total as P __.Lead _TCLP-Metals _ Solids, Total Phosphorus, Ortho as P _ Magnesium _ Solids, Total Dissolved _TCLP-Pestlcfdes _ Sulfates ..xlVianganese _ Solids, Total Volatile _TCLP-Herbicldes Surfactants _.:Mercury _TCLP-Volatlles _-'Mdytxteni«n ___TCLP-BNAs

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