NYC-WTC_000204891

NYC 9/11 Public Portal Document ALIO OO TONTZ 89697700 REW YORK CITY DEPARTMEN! OF HEALTH —- BUREAU OF PUBLA. HEALIN ENGUINELEING w. 2 LAFAYETTE STREET, 211TH FL, NEW YORK, NY. 10007 © TEL: (212) 676-1520 Fax: (212) 676-1517 ri _ REQUEST FOR BACTERIOLOGICAL ANALYSIS ro) od SAMPLING FOR U PUBLIC WATER SUPPLY Ut BOTTLED WATER QO BEACH WATER 2 POOL WATER O WELL WATER QQ WASTE WATER ~) OTHER o . = CHAIN-OFCUSTODY RECORD o Name of Sampling Location: Location Address: £2LU wD ZEKG Sampling Source. Date/Time Sample Taken: Sample(D. #: . ws 7 LASTS t-J2 & Jor Public Health Sanitanan. 1D: Water Run No: nA SAMPLE PREPARATION. Stored @4°C: D Yes Ro Tap: UAlamed Shor Flamed “ AS AAADCE SHoG Sr Complaint (CC#): a, in FIELD TESTING: = Chlorine Residual (ppm): pH. — Sample Temp (°C/*E}.— © Field Camments/Remarks: : wm | Recetved by Bureau of Labs [455 First Avenue, NY, NY 10076 Tel: (212) 447-4811} = pd | Date: Time: Sample Temp (‘C): Name: Signature: ” E22 Gg - 04 fo80 fie. Aw Und Lanes J tALog. = F y SAMPLING ANALYSES LAB NO: 1595 MULTIPLE TUBE DILUTIONS @HPN) MEMBRANE FILTER COUNT (MF) IML 0.) ML 0.01 ML 0.001 ML LT BG EC BG EC {T BG EC ty BG EC QUANTITY TOTAL FECAL FILTERED COLIFORM COLIFORM OTHER 24] 48 | 24 | 48 | 24] 24 | 48 | 24) 48 | 24 | 24 | 48 | 24 ¢ 4B | 24 | 244 48 | 24 | 484 24 " + {t+ + | 4+- He + ©) O z “4 pt + an r +} t r ‘) 2 [3 + yr i + f+ e) +) + b a | ee S15 Sf {2 o|O Coliform Couma(MPN pr a Feca) Collform Cow { (MP or MF/1 00m) Standard Plate Count ( /m) S 006 LA 2,200 3 Daie/lime Analyzed: Date/Time Reported: Bacterlotoglsi(s): Lab Commeuts/Remarks: a - st, o tee: ae any. a A A-24- 62 MAY 9 2002 VE a 2, om SP iach pahees | ™ - : — LASTS ey, _ ot * : LE OS FU AVE eon ace a PHE 102 (dag) NYC-WTC_000204891