NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
AG ENVIRONMENTAL RSC, LLC
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| 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051 | |||||||||||
| Bill-to Customer Information (C55068) | Water Source Location X55068-02 | ||||||||||
| Customer | |||||||||||
| Village of Red Hook | Source Name: | Village of Red Hook WW | |||||||||
| Name: | |||||||||||
| Address: | 7467 South Broadway | Address: | 7467 South Broadway | ||||||||
| Town: | RED HOOK | State: | NY | Zip: | 12571 | Town: | RED HOOK | State: | NY | Zip: | 12571 |
| Phone: | 000-000-0000 | PWSID/SPDES: | |||||||||
| Contact | |||||||||||
| Email: | treasurer@redhookvillage.gov | Les Coon | |||||||||
| Name: | |||||||||||
| Fax: | Phone: | 8455443151 | |||||||||
| Sample(s) delivered on | 10/02/2025 | at | 05:00 PM |
----- End of picture text -----
Original Report #: 77166 LCR Issue Date: 10/15/2025
From COC#: 73408
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| Sample# | MTX | Sample Point | Date & TimeSampled | [Temp] | Y/N/T | [Pres.] | ResCl | [Int] | Prep DateAnalyze | Analyte/Test Method | (see table)Comment | Results | MCL/SMCL(Limits) |
| Time | |||||||||||||
| SB00054204 | WW-G | INFLUENT | 10/02/2025 | 4.8°C | N | LJ | 10/03/2025 | BOD 5-Day SM 5210B Method | N | BOD, 5 day: 207 mg/L | |||
| 02:18 PM | G4 | 02:49 PM | BOD-00754 | ||||||||||
| DE | |||||||||||||
| SB00054203 | WW-G | INFLUENT | 10/02/2025 | 4.8°C | N | LJ | 10/06/2025 | Total Suspended Solids by SM22 2540D | N | Total Suspended Solids: 73.0 mg/L | |||
| 02:18 PM | G4 | 11:53 AM | Method | TS-00988 | |||||||||
| CJ | |||||||||||||
| SB00054202 | WW-G | EFFLUENT | 10/02/2025 | 4.8°C | N | ZJS 10/03/2025 | BOD 5-Day SM 5210B Method | N | BOD, 5 day: <2.0 mg/L | ||||
| 02:12 PM | G4 | 02:49 PM | BOD-00754 | ||||||||||
| DE | |||||||||||||
| SB00054201 | WW-G | EFFLUENT | 10/02/2025 | 4.8°C | N | ZJS 10/06/2025 | Total Suspended Solids by SM22 2540D | N | Total Suspended Solids: 2.7 mg/L | ||||
| 02:12 PM | G4 | 11:53 AM | Method | TS-00988 | |||||||||
| CJ | |||||||||||||
| SB00054200 | WW-G | EFFLUENT | 10/02/2025 | 4.8°C | Y | ZJS 10/06/2025 | Ammonia (as N) by EPA 350.1 Method | N | Ammonia (as N): <0.050 mg/L mg/L | ||||
| 02:12 PM | G4 | 11:19 AM | A00527 | ||||||||||
| DE | |||||||||||||
| SB00054199 | WW-G | EFFLUENT | 10/02/2025 | 4.8°C | T | ZJS 10/02/2025 | Fecal Coliform Count by Colilert-18 | N | Fecal Coliform: 5.2 MPN/100mL | ||||
| 02:12 PM | G4 | 05:15 PM | Method | 1759450576642 | |||||||||
| MV |
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Comment Table: N - No Comment | Remarks: T = Sodium Thiosulfate |
This report cannot be reproduced without written permission of Sullivan County Labs. Test results are limited to those methods under which our lab is certified by ELAP. Results only relate to actual samples received. The following information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested.
Authorized By:
Original Report #: 77166 Page 1 of (2)
COC# 73408
]
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| Cust. | ID; | 4847 | Ih | |||||||||||||||||||||||||||||||||||||
| Received: | 10/02/2025 | 5:00 PM | ||||||||||||||||||||||||||||||||||||||
| eno | a5 | |||||||||||||||||||||||||||||||||||||||
| w | SULLIVAN | COUNTY LABS | New | York | State | Chain-of-Custody | NON-POTABLE | |||||||||||||||||||||||||||||||||
| Water | sample | submission | form | cee | ||||||||||||||||||||||||||||||||||||
| CT | # | PH-o808 | ||||||||||||||||||||||||||||||||||||||
| 86 Queen Mountain | Road, Ferndale, | New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051 | min | i | ||||||||||||||||||||||||||||||||||||
| Bill-to | Customer | Information: | (C55068) | Well/System | Location | Information | 2025-09-30 | |||||||||||||||||||||||||||||||||
| ah | es | 01:10:18 | PM | |||||||||||||||||||||||||||||||||||||
| CustomerName: | ,ilage of Red Hook | ax a oieAe | EN(UN | OnePwae | illage of Red Hook WW | |||||||||||||||||||||||||||||||||||
| Address: | [7467 South | Broadway | — | ° | on | “Adiiess: | [7467 | South | Broadway | |||||||||||||||||||||||||||||||
| Town: | [RED | HOOK | ‘State: | NY | Zip: | 12571 | oe. | 2. | fg.(Tome~~ | IREDHOOK | State: | NY | Zip: | 12571 | ||||||||||||||||||||||||||
| Fa | ||||||||||||||||||||||||||||||||||||||||
| For | Phone: | 18455443151Village | of Red | HookWwhe | ] | |||||||||||||||||||||||||||||||||||
| forward | your | results | to | the | Dept. | of | Health. | Note: | It | is | your | responsibitity | to | verify | that they | receiveit. | ||||||||||||||||||||||||
| ‘Customer Sample Collection | Data | |||||||||||||||||||||||||||||||||||||||
| potte Sample# | c/G | sample | Point. | SampledDate | SampledTime | initialsSampled Who | Test Requested | -ELAP/EPA Method | SamplComm | e | nts/Temp | |||||||||||||||||||||||||||||
| 5B00054203 | - | 2-2e23 | 24g | NO | CF | Total Suspended | Solids | by SM22 | 25400 Method = | |||||||||||||||||||||||||||||||
| $B00054202 | gz | @eF | BOD 5-Day SM 52108 Method | |||||||||||||||||||||||||||||||||||||
| SB00054200$B00054201 | 2217® | , | » | otal | Suspended | Solids | by $M22 | 25400 Method“> | ||||||||||||||||||||||||||||||||
| a | 2ii2 | Zrs> | ] | mmonia | (as n) by EPA 350.1 | Method | =F/OH}|(>) | |||||||||||||||||||||||||||||||||
| seocosaios | e] | erie | w.2-2ead | 2g | O | C2SS> | FealCoitrmcaunenycolersiamenoa [7] | |||||||||||||||||||||||||||||||||
| Lie | OR | ane | ee | ff | Received | Received | . | i | ||||||||||||||||||||||||||||||||
| ullivan | County | Labs terms | and | conditions | found | on | www.SulllvanCountyLabs.com. | Public | water systems | are required | to | [Sport | results | to the | locaf | Dept. | of Health | office, When | necessary, | we | reserve | the | right | to subcontract | testing | to | accredited | laboratories | that are | certified | by the | state | from | ; | i | |||||
| hich | the sample was taken. | Circumstances | might | require | us | to | send | your sarnple | to | an | affiliated | lab, | either due | to | instrument | backiag, | hold | time | limitations, | or non-accreditation | in | a | particular | test. | You | are giving | us | permission | to | do so by signing | this | COC. | The | alternate | tab | will | be shown | on | your | iy |
| Keritificate | of | results | with | its | approved | ELAP | #. | The | following | information | is | provided | by | the | customer | and notby | the | laboratory: | Source informatio:, | matrix, sample | point, sampled | date/time, | residual chlorine, | initials, anc test requested. | ; ; |
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AG ENVIRONMENTAL RSC, LLC
NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
| AG ENVIRONMENTAL RSC, LLC | AG ENVIRONMENTAL RSC, LLC | GEESEEEEE SEE aE EEaeSe ae Ee ae Ee Ee Se ae | = | - | ~~Co | GEESEEEEE SEE aE EEaeSe ae Ee ae Ee Ee Se ae | = | - | ~~Co | GEESEEEEE SEE aE EEaeSe ae Ee ae Ee Ee Se ae | = | - | ~~Co | GEESEEEEE SEE aE EEaeSe ae Ee ae Ee Ee Se ae | = | - | ~~Co | NYSDOH ELAP # 12081 | | - | - | = | =) | ~~ | a jeche a | = | =) | ~~ | a jeche a | = | =) | ~~ | a jeche a | = | =) | ~~ | a jeche a | PA DEP # 68-05705 | | - | - | - | LABORATORYCERTIFICATEOFRESULTS | - | ee7 bed a peLeak joea jeSe a | - | LABORATORYCERTIFICATEOFRESULTS | - | ee7 bed a peLeak joea jeSe a | - | LABORATORYCERTIFICATEOFRESULTS | - | ee7 bed a peLeak joea jeSe a | - | LABORATORYCERTIFICATEOFRESULTS | - | ee7 bed a peLeak joea jeSe a | FLORIDA (Legionella) # E871152 | | - | - | - | i | - | eeeas A a | - | i | - | eeeas A a | - | i | - | eeeas A a | - | i | - | eeeas A a | Connecticut # PH-0808 | | - | - | - | - | - | ee a | - | - | - | ee a | - | - | - | ee a | - | - | - | ee a | te | | - | - | - | - | - | eeRh eh jae a | - | - | - | eeRh eh jae a | - | - | - | eeRh eh jae a | - | - | - | eeRh eh jae a | - | | - | - | - | - | - | Sehy peae | - | - | - | Sehy peae | - | - | - | Sehy peae | - | - | - | Sehy peae | - | |86Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051|||||Original Report #: 77165 LCR Issue Date: 10/15/2025|| |Bill-to Customer Information(C55068)|||Water Source Location X55068-02|||| |Customer Name:|Village of Red Hook||Source Name:|Village of Red Hook WW||| |Address:|7467 South Broadway||Address:|7467 South Broadway||| |Town:|RED HOOKState:NYZip:12571||Town:|RED HOOKState:NYZip:12571||| |Phone:|000-000-0000||PWSID/SPDES:|||| |Email:|treasurer@redhookvillage.gov||Contact Name:|Les Coon||| |Fax:|||Phone:|8455443151||| |Sample(s) delivered on10/03/2025at02:21 PM|||||**From COC#:**73449||
|Sample#|MTX|Sample Point|Sampled **Date & Time **|**Temp **|Pres. Y/N/T|Res **Cl **|Int|Analyze Prep Date Time|Analyte/Test Method|Comment (see table)|Results|MCL/SMCL (Limits)| |---|---|---|---|---|---|---|---|---|---|---|---|---| |SB00054384|WW-G|EFFLUENT|10/03/2025 12:43 PM|8.2°C G4|T||LJ|10/03/2025 04:08 PM MV|Fecal Coliform Count by Colilert-18 Method|N 1759532929198|Fecal Coliform: 18.5 MPN/100mL|| |SB00054385|WW-G|EFFLUENT|10/03/2025 12:43 PM|8.2°C G4|Y||LJ|10/06/2025 11:19 AM DE|Ammonia (as N) by EPA 350.1 Method|N A00527|Ammonia (as N): <0.050 mg/L mg/L|| |SB00054386|WW-G|EFFLUENT|10/03/2025 12:43 PM|8.2°C G4|N||LJ|10/06/2025 11:53 AM CJ|Total Suspended Solids by SM22 2540D Method|N TS-00988|Total Suspended Solids: 1.6 mg/L|| |SB00054387|WW-G|EFFLUENT|10/03/2025 12:43 PM|8.2°C G4|N||LJ|10/03/2025 02:49 PM CW|BOD 5-Day SM 5210B Method|N BOD-00754|BOD, 5 day: <2.0 mg/L|| |SB00054388|WW-G|INFLUENT|10/03/2025 12:37 PM|8.2°C G4|N||ZJS 10/06/2025|ZJS 10/06/2025 11:53 AM CJ|Total Suspended Solids by SM22 2540D Method|N TS-00988|Total Suspended Solids: 132.0 mg/L|| |SB00054389|WW-G|INFLUENT|10/03/2025 12:37 PM|8.2°C G4|N||ZJS 10/03/2025|ZJS 10/03/2025 02:49 PM CW|BOD 5-Day SM 5210B Method|N BOD-00754|BOD, 5 day: 144 mg/L||
Comment Table: N - No Comment | Remarks: T = Sodium Thiosulfate |
This report cannot be reproduced without written permission of Sullivan County Labs. Test results are limited to those methods under which our lab is certified by ELAP. Results only relate to actual samples received. The following information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested.
Authorized By:
Original Report #: 77165 Page 1 of (2)
Se
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COC-WW Form. Ver. 9 :
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pos SULLIVAN COUNTY LABS New York State Chain-of-Custody NON-POTAB LE NYSDOH ELAP# 12081 :
: Water sample submission form FLORIDA (Lesionalis) + eb71152 H
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86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051 COC# 73449 ;
. Cust. ID; 4847
. . . . Received: 10/03/2025 2:21 PM 4
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illage fR "
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Fax:Phone: [(8455443151] :
notes:‘orward Plant 1-Bhe| |
your results to the Dept. of Health. Note: itis your responsibility to verify that they receive it. 4
Customer Sample Collection Data
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ullivan County Labs terms and conditions found on www.SullivanCountyLabs.com. Public water systems are required to report results to the jocal Dept. of Health office. When necessary, we reserve the right to subcontract testing to accredited jaboratorles that are certified by the state from x
hich the sample was taken. Circumstances might require us to send your sample to an affiliated lab, either due to instrument backlog, hold time limitations, ar non-accreditation in a particular test, You are giving us permission to do so by signing this COC. The alternate lab witl be shown on your f
ceritificate of resuits with its approved ELAP #. The follawing Information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested. :
----- End of picture text -----
AG ENVIRONMENTAL RSC, LLC
Ce 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051
NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
Original Report #: 77853
a Bill-to Customer Information (C55068) Water Source Location X55068-02 LCR Issue Date: 10/30/2025 Customer Village of Red Hook Source Name: Village of Red Hook WW Name:
a Address: 7467 South Broadway Address: 7467 South Broadway a Town: GG RED HOOK State: NY Zip: 12571 Town: RED HOOK State: NY Zip: 12571 a Phone: GQ 000-000-0000 PWSID/SPDES: Contact Email: treasurer@redhookvillage.gov Les Coon Name: a Fax: GQ Phone: 8455443151 Sample(s) delivered on 10/23/2025 at 04:20 PM From COC#: 74419
|**Sample# **|MTX|Sample Point|Sampled Date & Time|**Date & TimeTemp **|Pres. Y/N/T|Res Cl|Int|Analyze Prep Date Time|Test Method|Comment (see table)|Analyte|Results|MCL (Limits)|SMCL (Limits)| |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| |SB00054684|WW|EFFLUENT|10/23/2025 01:38 PM|4.3°C G5|T||Zac Simmons|10/23/2025 04:36 PM BK|Fecal Coliform Count by Colilert-18 Method|N 1761251798125|1761251798125Fecal Coliform|2419.6 MPN/100mL||| |SB00054685|WW|EFFLUENT|10/23/2025 11:26 AM|4.3°C G5|Y||Zac Simmons|10/24/2025 10:04 AM YP|Ammonia (as N) by EPA 350.1 Method|N A-00537|Ammonia (as N)|0.072 mg/L||| |SB00054686|WW|EFFLUENT|10/23/2025 11:26 AM|4.3°C G5|N||Zac Simmons|10/27/2025 08:44 AM CJ|Total Suspended Solids by SM22 2540D Method|N TS-00997|Total Suspended Solids|1.2 mg/L||| |SB00054687|WW|EFFLUENT|10/23/2025 11:26 AM|4.3°C G5|N||Zac Simmons|10/24/2025 12:57 PM CW|BOD 5-Day SM 5210B Method|N BOD-00765|BOD, 5 day|<2.0 mg/L||| |SB00054688|WW|INFLUENT|10/23/2025 11:26 AM|4.3°C G5|N||Zac Simmons|10/27/2025 08:44 AM CJ|Total Suspended Solids by SM22 2540D Method|N TS-00997|Total Suspended Solids|62.0 mg/L||| |SB00054689|WW|INFLUENT|10/23/2025 11:26 AM|4.3°C G5|N||Zac Simmons|10/24/2025 12:57 PM CW|BOD 5-Day SM 5210B Method|N BOD-00765|BOD, 5 day|167 mg/L|||
Comment Table: N - No Comment |
Remarks: T = Sodium Thiosulfate |
This report cannot be reproduced without written permission of Sullivan County Labs. Test results are limited to those methods under which our lab is certified by ELAP. Results only relate to actual samples received. The following information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested.
Authorized By:
Original Report #: 77853 Page 1 of (2)
coc# 74419 = Cust. ID: 4847 9 Received: 10/23/2025 4:20 PM
'
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. AG ENVIRONMENTAL, RSC, LLC. “ SULLIVAN COUNTY LABS New York State Chain-of-Custody. NON-POTABL Water sample submission form Bill-to 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051 min : Customer Information: (C55068) Well/System Location Information 2025-10-06 03:11:15 PM ustomer : : Name or . Town:Address: [RED[7467illage HOOKSouth of Red Hook~—sBroadway State: NY Zip: 12571 __ffown:Address:[7467REDillage HOOKSouth of Red Hook BroadwayState: WWNY Zip: 12571 ||: Pws- | Fax, Phones 18055443151 aot 1.0 CRR-NY 5-1.74 of the NY State Code requires the owner of a public water system shail ensure the approved environmental laboratory performing the analyses sends taboratory results to the Dept. of Health ina manner prescribed by them. Initialhere if you want uste__ | Customer és | Sample Collection Data S | [Botte : Date Time Initials Who Comments/ | li} seooosaesaSample#iC/G|Sample| |ettuentPoint| yofez/asSampled | 238Sampled AO] Zan SampledSimmons FecalTestColiform Requested Count- by ELAP/EPA Colilert-18 Method Method | Sample Temp || seooosaeas [| [even [| | | ae [| foal Suspendee solos bysuzz 25400 Neto ssooosaeer [| ement | fT fae te epmastiraaetasmenos | [||] hh. “a en Se | Ca 2 a Relinquishedinqui By’:ee J, foee a= staat | RelinquishedRelinquished To: To:| ‘Sun | ReceivedDate /6423425, ReceivedTime {42‘yy, a - A, } / Received Received : fY By signing, customer acknowledges that some samples may be sent to’a sister (certified) LAB for analysis. Samples cannét he leg geen pid turnaround time clock will not start until any ambiguities are resolved. By executing this document, the cllent has read and agrees to be bound by i Suilivan County Labs terms and conditions found on wwew.SullivanCountyLabs.com. Public water systems are required to report results te’the local Dept, of Heaith office. When necessary, we reserve the right to subcontract testing to accredited laboratories that are certified by the staté from H Wwhich the sample was taken, Circumstances might require us to send your sample to an affiliated jab, either due to instrument backlog, hold time limitations, or non-accreditation in a particular test. You are giving us permission to do so by signing this COC, The alternate jab will be shown on your E i ----- End of picture text -----
AG ENVIRONMENTAL RSC, LLC
Ce 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051
NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
Original Report #: 78052
a Bill-to Customer Information (C55068) Water Source Location X55068-02 LCR Issue Date: 11/04/2025 Customer Village of Red Hook Source Name: Village of Red Hook WW Name:
a Address: 7467 South Broadway Address: 7467 South Broadway a Town: GG RED HOOK State: NY Zip: 12571 Town: RED HOOK State: NY Zip: 12571 a Phone: GQ 000-000-0000 PWSID/SPDES: Contact Email: treasurer@redhookvillage.gov Les Coon Name: a Fax: GQ Phone: 8455443151 Sample(s) delivered on 10/23/2025 at 04:20 PM From COC#: 74417
|**Sample# **|MTX|Sample Point|Sampled **Date & Time **|**Temp **|Pres. Y/N/T|Res **Cl **|Int|Analyze Prep Date Time|Test Method|Comment (see table)|Analyte|Results|MCL (Limits)|SMCL (Limits)| |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| |SB00054690|WW|EFFLUENT|10/23/2025 12:57 PM|4.3°C G5|T||ZJS|10/23/2025 04:36 PM BK|Fecal Coliform Count by Colilert-18 Method|N 1761251798125|1761251798125Fecal Coliform|1986.3 MPN/100mL||| |SB00054691|WW|EFFLUENT|10/23/2025 12:00 PM|4.3°C G5|Y||ZJS|10/24/2025 10:04 AM YP|Ammonia (as N) by EPA 350.1 Method|N A-00537|Ammonia (as N)|0.183 mg/L||| |SB00054692|WW|EFFLUENT|10/23/2025 12:00 PM|4.3°C G5|N||ZJS|10/27/2025 08:44 AM CJ|Total Suspended Solids by SM22 2540D Method|N TS-00997|Total Suspended Solids|55.6 mg/L||| |SB00054693|WW|EFFLUENT|10/23/2025 12:00 PM|4.3°C G5|N||ZJS|10/24/2025 12:57 PM DE|BOD 5-Day SM 5210B Method|N BOD-00765|BOD, 5 day|17.5 mg/L||| |SB00054694|WW|INFLUENT|10/23/2025 12:00 PM|4.3°C G5|N||ZJS|10/27/2025 08:44 AM CJ|Total Suspended Solids by SM22 2540D Method|N TS-00997|Total Suspended Solids|280.0 mg/L||| |SB00054695|WW|INFLUENT|10/23/2025 12:00 PM|4.3°C G5|N||ZJS|10/24/2025 12:57 PM DE|BOD 5-Day SM 5210B Method|N BOD-00765|BOD, 5 day|181 mg/L|||
Comment Table: N - No Comment |
Remarks: T = Sodium Thiosulfate |
This report cannot be reproduced without written permission of Sullivan County Labs. Test results are limited to those methods under which our lab is certified by ELAP. Results only relate to actual samples received. The following information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested.
Authorized By:
Original Report #: 78052 Page 1 of (2)
Se,
COC# 74417 : Cust. 1D: 4847 9 E Received; 10/23/2025 4:20 PM | | | LACEY i 2025-10-06 03:13:16 PM : 12571 | — a GS Method SampleComments/ TempComments/ Temp Temp | | Method es | | : Received q; ‘ | Time 142 | Received Time 230 on | | laboratories that are certified by the statelfrom are certified by the statelfrom certified by the statelfrom by the statelfrom the statelfrom statelfrom H this COC. The alternate COC. The alternate The alternate alternate lab wif be shown en your wif be shown en your be shown en your shown en your en your your $ |
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----- Start of picture text -----
| y | Received; | 10/23/2025 | 4:20 | PM | ||||||||||||
| AG | ENVIRONMENTAL, | RSC, | LLC. | |||||||||||||
| SULLIVAN | . | |||||||||||||||
| Water | COUNTY LABS | New York State | Chain-of-Custody | NON-POTABL | ||||||||||||
| sample submission form | ||||||||||||||||
| Bill-to | 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051 | LACEY | ||||||||||||||
| Customer | Information: | (C55068) | Well/System | Location | Information | 2025-10-06 | ||||||||||
| ustomer | 03:13:16 | PM | ||||||||||||||
| Address: | illage. | of Red Hook | Name | or | iliage. | of Red Hook WW | ||||||||||
| Town: | [7467 South Broadway | Address: | (7467 South Broadway | |||||||||||||
| 5 | [RED HOOK | State: | NY | Zip: 12571 | Town: | [RED | HOOK | ‘State: | NY | Zip: | 12571 | |||||
| 7 | PWS- | |||||||||||||||
| ; | F | ontact | ||||||||||||||
| Fa | Prone: | sass | — | |||||||||||||
| forward | your | results | to | the Dept. | of | Heaith. | Note: | tt | is | your responsibility | to | verify | that | the: | receive | it, |
| Customer | Sample | Collection | Data | |||||||||||||
| [porte Sample#/C/G | Sample Point: | SampledDate | SampledTime | InitialsSampled Who | Test Requested | - ELAP/EPA Method | SampleComments/ TempComments/ Temp Temp | |||||||||
| ~/11} | ||||||||||||||||
| $B00054690 | Effluent | 1/23 | LZ | EF | ARS | 1 | “Za. | 7 | ||||||||
| Fecal | Coliform | Count | by | Colilert-18 | Method | |||||||||||
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| hich | County Labs terms and conditions found on www.SulllvanCountyLabs.com. | Public water systems are required to renettréSults to the local Dept. of Health office, When necessary, | we reserve the right to subcontract testing to accredited | laboratories that are certified by the statelfrom are certified by the statelfrom certified by the statelfrom by the statelfrom the statelfrom statelfrom | ||||||||||||
| the sample was taken. Circumstances | might require us to send your sample | to an affiliated | lab, either due to instrument backlog, | hold time limitations, or non-accreditation | in a | particular test. You are giving us permission to do so by signing | this COC. The alternate COC. The alternate The alternate alternate | lab wif be shown en your wif be shown en your be shown en your shown en your en your your | ||||||||
| ceritificate of results with its approved ELAP #, The following information | is provided | by | the customer and not by the laboratory: Source information, matrix, sample | point, sampled date/time, residual chiorine, | initials, and test requested, |
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NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
AG ENVIRONMENTAL RSC, LLC
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PA DEP # 68-05705
FLORIDA (Legionella) # E871152
Connecticut # PH-0808
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|---|---|---|---|---|---|---|
|86Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051|||||Original Report #: 77846
LCR Issue Date: 10/30/2025||
|Bill-to Customer Information(C55068)|||Water Source Location X55068-02||||
|Customer
Name:|Village of Red Hook||Source Name:|Village of Red Hook WW|||
|Address:|7467 South Broadway||Address:|7467 South Broadway|||
|Town:|RED HOOKState:NYZip:12571||Town:|RED HOOKState:NYZip:12571|||
|Phone:|000-000-0000||PWSID/SPDES:||||
|Email:|treasurer@redhookvillage.gov||Contact
Name:|Les Coon|||
|Fax:|||Phone:|8455443151|||
|Sample(s) delivered on10/28/2025at02:35 PM|||||**From COC#:**74540||
Original Report #: 77846 LCR Issue Date: 10/30/2025
|**Sample# **|MTX|Sample Point|Sampled Date & Time|**Temp **|Pres. Y/N/T|Res **Cl **|Int|Analyze Prep Date Time|Test Method|Comment (see table)|Analyte|Results|MCL (Limits)|SMCL (Limits)| |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| |S000279331 WW-G|S000279331 WW-G|EFF. B|10/28/2025 12:13 PM|7.1°C G1|T|N/A|LJ|10/28/2025 03:16 PM MN|Fecal Coliform Count by Colilert-18 Method|N 1761678981229|1761678981229Fecal Coliform|>2419.6 MPN/100mL|||
Comment Table: N - No Comment | Remarks: T = Sodium Thiosulfate |
This report cannot be reproduced without written permission of Sullivan County Labs. Test results are limited to those methods under which our lab is certified by ELAP. Results only relate to actual samples received. The following information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested.
Authorized By:
Kylea May | Document Control
Original Report #: 77846 Page 1 of (1)
:
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cocé 74540 Cust. ID: 4847 ; Received: 10/28/2025iii2:35iii2:35 PM | |
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| AG | i | ; | Received: | 2:35 | PM | |||||||||||||
| Environmental86 | Queen | Mountain— NewRd. | Ferndale, York StateNY 12734 Chain-of-Custody | WASTEWATER | 10/28/2025iii2:35iii2:35 | |||||||||||||
| Bill-to | / | Phone 845-704-8151 / Fax: 845-414-0051 | ||||||||||||||||
| Customer | Information | System | Location | Information | ||||||||||||||
| Customer | . | H | ||||||||||||||||
| Name: | Village | of Red | Hook | Village | of Red | Hook WWTP | ||||||||||||
| Address: | 7467 | South | Broadway | Address: | 7467 South | Broadway | ||||||||||||
| Town: | [Red | Hook | state | WY | [ap[ tart | Town: | [Red Hook | Bee | Feleey) | |||||||||
| Phone: | [845-758-1081 | a | ||||||||||||||||
| treasurer@redhookvillage.gov | Contact Name | /Les Coon | ||||||||||||||||
| Fave | [846-758-5460 | Phone: | [24s-544-9151 | |||||||||||||||
| of Health, Note: /t | is your responsibility | to | verify | that they receive | it, | . | ||||||||||||
| ; | Customer Sample | Collection | Data | |||||||||||||||
| Bottle Sample # | Sample Point: | SampledDat | SampledTime | ChlorineResidual | Initials Wh | Test Requested — ELAP/EPA Method | Comments/Sample Temp | |||||||||||
| 1 | @ | =cee | tefz,jePa 2'3, | nif | &‘J __ | Fecal Coliform: | by Colilert-18. | Method | B | fle | ||||||||
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| terms* By signing, customer acknowled gf that some samples may be sent to a sister (certified} LAB for analysis. Samples cannot be logged | in and turnaround time clock will | not start until any ambiguities are resolved, | By.executing this document, the client has read and agrees to be bound by Sulfiyén County Labs | |||||||||||||||
| and conditions found on www,SullivanCountyLabs,com. | Public water systems are required | to report results to the local | Dept. of Health | office. When | necessary, we reserve the right to subcontract testing to accredited | laboratories that are certified by the state from which | the sample | was taken. | ||||||||||
| picumstances might require us to-send your sample to an affiliated | lab, either due to instrument backlog, hold time limitations, or non-accreditation | in a particular | test. You are giving us permission to do so by signing this COC. The alternate lab will be shown on your certificate of results with | its appraved |
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NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
AG ENVIRONMENTAL RSC, LLC
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| 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051 | Original Report #: 77847 | ||||||||||
| Bill-to Customer Information (C55068) | Water Source Location X55068-02 | LCR Issue Date: 10/30/2025 | |||||||||
| Customer | |||||||||||
| Village of Red Hook | Source Name: | Village of Red Hook WW | |||||||||
| Name: | |||||||||||
| Address: | 7467 South Broadway | Address: | 7467 South Broadway | ||||||||
| Town: | RED HOOK | State: | NY | Zip: | 12571 | Town: | RED HOOK | State: | NY | Zip: | 12571 |
| Phone: | 000-000-0000 | PWSID/SPDES: | |||||||||
| Contact | |||||||||||
| Email: | treasurer@redhookvillage.gov | Les Coon | |||||||||
| Name: | |||||||||||
| Fax: | Phone: | 8455443151 | |||||||||
| Sample(s) delivered on | 10/28/2025 | at | 02:35 PM | From COC#: | 74538 |
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Original Report #: 77847 LCR Issue Date: 10/30/2025
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| Analyze | |||||||||||||||
| Sample | Sampled | Res | Comment | MCL | SMCL | ||||||||||
| Sample# | MTX | Point | Date & Time | Temp | Y/N/T | [Pres.] | Cl | [Int] | Prep Date | Test Method | (see table) | Analyte | Results | (Limits) | (Limits) |
| Time | |||||||||||||||
| 10/28/2025 | |||||||||||||||
| EFF. | 10/28/2025 | 7.1°C | Fecal Coliform Count by | N | |||||||||||
| S000279330 WW-G | T | N/A | LJ | 03:16 PM | 142.5 MPN/100mL | ||||||||||
| A | 12:34 PM | G1 | Colilert-18 Method | 1761678981229 | [Fecal Coliform] | ||||||||||
| MN |
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Comment Table: N - No Comment | Remarks: T = Sodium Thiosulfate |
This report cannot be reproduced without written permission of Sullivan County Labs. Test results are limited to those methods under which our lab is certified by ELAP. Results only relate to actual samples received. The following information is provided by the customer and not by the laboratory: Source information, matrix, sample point, sampled date/time, residual chlorine, initials, and test requested.
Authorized By:
Kylea May | Document Control
Original Report #: 77847 Page 1 of (1)
| | : | | | | | |
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Ss oo ONC Form. Ver. 10 AG Environ ° . _ cott 74538 | Ms acoomental New York State Chain-of-Custody WASTEWATE! —ecsives:10)20;206Cust. tp; 4 9.35 on 86 Queen Mountain Rd. Ferndale, NY 12734 / Phone 845-704-8151 Bill-to Customer Information System/ Fax: 845-414-0051Location Information | |ll|||Hi|| Customer |\ ;: : ’ - Name. | Willage of Red Hook Village of Red Hook WWTP Address: | 7467 South Broadway 12777 | Address: 7467 South Broadway ww" 1} Town: [Red Hook State Wyn] tem | Town: [Red Hook State] NY [eel |Phone: aaret| Email [845-758-1081 SPEDES | Csr [Fax [945-756-5460| treasurer@redhookvillage.gov Phone:Contact Name[045543061 _ |Les Coon ----- End of picture text -----
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| of Health. Note: | it is your responsibility to | verify that they receive | it. | |||||||||||
| ; | Customer | Sample | Collection | Data | ||||||||||
| Bottle Sample # | Sample Point: | sampledDa | SampledTime | chlorineResiduat | Initials | WI | Test Requested — ELAP/EPA Method | Comments/Sample Temp | ||||||
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| * By signing, customer acknowledgg | hnfsome samples may be sent to a sister (certified) LAB for | analysis, Samples cannot be logged | in and turnaround | time clock will not start until any ambiguities are resolved. By executing this document, | the client has read and agrees to be bound by Sullivaf | County | Labs | |||||||
| terms and conditions found on www.SullivanCountyLabs.com. | Public water systems | are required to report | results to the | local Dept. | of Health | office. When | necessary, we reserve the | right to subcontract testing to accredited | laboratories | that are | certified | by the state from which the sample | wa’ | taken, |
| pircumnstances might require us to-send your sample to an affiliated lab, either | due to instrument backlog, hold time limitations, or nan-accreditation | in a particular test. You are giving us permission to do so by signing this COC. The alternate | fab will be shown on | your certificate af results with Hts appraved |
----- End of picture text -----
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