AG ENVIRONMENTAL RSC, LLC
NYSDOH ELAP # 12081 PA DEP # 68-05705 FLORIDA (Legionella) # E871152 Connecticut # PH-0808
Ce 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845.704.8151 / Fax: 845.414.0051
Original Report #: 78698 a Bill-to Customer Information (C55068) Water Source Location X55068-01 LCR Issue Date: 11/17/2025 Customer Village of Red Hook Source Name: Village of Red Hook DW Name: a Address: GC 7467 South Broadway Address: 7467 South Broadway a Town: a 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: FIST Fax: Phone: 8455443151 a ee GO Sample(s) delivered on 11/13/2025 at 05:05 PM From COC#: 75501
|**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|Analyte Results|MCL
(Limits)|SMCL
(Limits)|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|SB00055614
ee|DW-G
ee|16E. MARKET ST
ee|11/13/2025
08:24 AM
ee|6.0°C
G1
ee|T
ee|1.29 LC
ee|1.29 LC
ee|11/14/2025
12:31 PM
MN|Coliform P/A & E.coli by SM22
9223B (Colilert) Method|N
1763141505659
eee|Coliform
eee
es|Absence
eee
ee|Zero
eee
ee|eee
ee|
||||||||||||E.coli
eee
es|Absence
eee
ee|Zero
eee
ee|eee
ee|
|SB00055613
ee|DW-G
ee|VILLAGE HALL
ee|11/13/2025
09:14 AM
ee|6.0°C
G1
ee|T
ee|0.87 LC
ee|0.87 LC
ee|11/14/2025
12:31 PM
MN
ee|Coliform P/A & E.coli by SM22
9223B (Colilert) Method
ee|N
1763141505659
ee|Coliform
es
ee
a|Absence
~~ee ~~
ee
a|Zero
ee
ee
ee|ee
ee|
||||||||||||E.coli
ee
a|Absence
ee
a|Zero
ee
ee|ee|
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:
Montana Papacharalambous | Document Control
Original Report #: 78698 Page 1 of (1)
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TTT COC-DW VER 11.0 ~~"« AGWater ENVIRONMENTAL,SULLIVAN COUNTYRSC,LABS LLc. New York State Chain-of-Custody POTABLE WATER wysoonisSoe# ainaut CFA || sample submission form FLORI IDA (Legionella)DEP# 68-0705# £871152 CT # PH-Of0R 86 Queen Mountain Road, Ferndale, New York, 12734 / Phone: 845,704,815] / Fax: 845.414.0051 Cust.coc#1D:7550)4 { : . . Received: 11/13/2025 5:05 PM Bill-toustomer Customer[| Information: (C55068) ell/System Location Information AAT Name: ) | | Address: [7467illageSouth of Red HookBroadwa address:ear |[7467illageSouth of RedBroadwa Hook DW Town:|RED HOOK State: NY _Zip: 12571 frown: RED HOOK ‘State: NY _Zip: 12571 | Fax: " | Please send|my report | Phone: (8455443151= | 0 DOH. 10 | Village of Red Hook DW 1 ie: | ) CRR-NY 5-1.74 of the NY State Code requires the owner of a public water system shall ensure the approved environmental laboratory pe ierming the analvees conde laboratory results to the Dept. of Health in a manner prescribed by them. Initial here if you want us to | forward your results to the Dept. of Health. Note: it is your responsibility to verify that they receive it. a — 1 Customer Sampie Collection Data : h}[ Bottlespoo0ssel4 Sampte#!p Sam[iG MackeASdlple Point: (/13/2SampledDate 8 [yeeSampledTimeae in ChlorineResidual: ColiformTestP/A Requested-ELAP/EPA & E.coli by SM22- 92238 (Colilert) MethodMethod T SampleComment Tempnts/ tAa| pre : | A AIP gi 2p,= of Ra= a . pe a . Received | Received tae | ae +, Ly a ; (/ y Received Received IO me Relinquished By : ) Relinquished To: an Date a Time 5 . Gi ! Sullivan 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 st#ite from hich the sample was taken. Circumstances might require us to send yaur sample to an affiliated lab, either due to instrument backlog, haid time limitations, or non-accreditation in a particular test. You are giving us permissicn to do so by signing this COC. The alternate fab will be shown on your eritificate 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 chlorine, Initials, and test requested, ----- End of picture text -----
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