Please complete and return to: New York State Department of Health Complete if Applicable: Wadsworth Center - Environmental Laboratory Approval Program PO BOX 509 - Empire State Plaza LAB ID# ______Albany, NY 12201-0509 Phone: (518) 485-5570 Fax: (518) 473-8117 email: [email protected] APPLICATION for PRIMARY ACCREDITATION - SOLID AND CHEMICAL MATERIALS 180.3. Laboratory Name: Address: City.State, Zip:
If New York ELAP is your laboratory's primary NELAC accreditor, you must include the following for each analyte for which approval is requested: ____Demonstration of Capability (DOC) form, ____DOC summary/supporting data, and ____Standard Operating Procedure To complete this form, please place an "A" on the line preceding each analyte name to indicate an addition to your scope of accreditation. If you wish to remove an analyte from your scope, place an "E" on the line preceding each analyte name. Also, please cite the determinant and/or prep method you wish to add or erase by using the "ELAP Method Number" listed in the Certification Manual Item 180.3. For example, cite PCB-1016 by GC-ECD using EPA 8082A and EPA 3550C as "4308" and "4051". An application that omits any of this information will be considered incomplete.
Is the application request for additions ("A") for NYS work (i.e. will analysis be performed on NYS samples)? ___Y ___N Does your lab wish to participate in NYS DOH PT studies for those fields of accreditation that have a PT requirement? ___ Y ___ N ELAP Method No. ELAP Method No.
Characteristic Testing Metals I Ignitability Strontium, Total
Corrosivity Metals II
E.P. Toxicity Aluminum, Total
TCLP Antimony, Total
Synthetic Precipitation Leaching Proc. Arsenic, Total
Multiple Extraction Procedure Beryllium, Total
Free Liquids Chromium VI Lithium, Total Metals I Barium, Total Mercury, Total
Cadmium, Total Selenium, Total
Calcium, Total Vanadium, Total
Chromium, Total Zinc, Total
Copper, Total Metals III
Iron, Total Cobalt, Total
Lead, Total Molybdenum, Total
Nickel, Total Thallium, Total
Magnesium, Total Tin, Total
Manganese, Total Titanium, Total
Potassium, Total Silica, Dissolved
Silver, Total Acrylates Acrolein (Propenal) Sodium, Total
DOH-1977 ( 1/26/2018 ) -1- ELAP Method No. ELAP Method No. Nitroaromatics and Isophorone Acrylates 4-Nitroquinoline-1-oxide
Acrylonitrile 2-Nitrotoluene
Ethyl methacrylate 3-Nitrotoluene
Methyl acrylonitrile 4-Nitrotoluene
Methyl methacrylate Nitrobenzene
Chlorinated Hydrocarbons Nitroglycerine 1-Chloronaphthalene Octahydro-tetranitro-tetrazocine 2-Chloronaphthalene Pentaerythritol tetranitrate Hexachlorobenzene Pyridine Hexachlorobutadiene 1,3,5-Trinitrobenzene Hexachlorocyclopentadiene 2,4,6-Trinitrotoluene Hexachloroethane 2,4,6-Trichloronitrobenzene Hexachlorophene Phthalate Esters Hexachloropropene Benzyl butyl phthalate
Pentachlorobenzene Bis(2-ethylhexyl) phthalate
1,2,3-Trichlorobenzene Diethyl phthalate
1,2,4-Trichlorobenzene Dimethyl phthalate
1,3,5-Trichlorobenzene Di-n-butyl phthalate
1,2,4,5-Tetrachlorobenzene Di-n-octyl phthalate
Haloethers Polychlorinated Biphenyls Bis(2-chloroethyl)ether PCB-1016
Bis(2-chloroethoxy)methane PCB-1221
2,2'-Oxybis(1-chloropropane) PCB-1232
4-Bromophenylphenyl ether PCB-1242
4-Chlorophenylphenyl ether PCB-1248
Chloromethylmethyl ether PCB-1254
Nitroaromatics and Isophorone PCB-1260 2-Amino-4,6-dinitrotoluene PCB-1262 4-Amino-2,6-dinitrotoluene PCB-1268 3-Chloromethyl pyridine-HCl PCBs in Oil 4-Dimethylaminoazobenzene PCB 1 2,4-Dinitrotoluene PCB 2 2,6-Dinitrotoluene PCB 3 3,5-Dinitroaniline PCB 4 1,2-Dinitrobenzene PCB 5 1,3-Dinitrobenzene PCB 6 1,4-Dinitrobenzene PCB 7 Hexahydro-1,3,5-trinitro-1,3,5-triazine PCB 8 Hydroquinone PCB 9 Isophorone PCB 10 Methyl-2,4,6-trinitrophenylnitramine PCB 11 1,4-Naphthoquinone PCB 12
DOH-1977 ( 1/26/2018 ) -2- ELAP Method No. ELAP Method No. Polychlorinated Biphenyls Polychlorinated Biphenyls PCB 54
PCB 13 PCB 55
PCB 14 PCB 56
PCB 15 PCB 57
PCB 16 PCB 58
PCB 17 PCB 59
PCB 18 PCB 60
PCB 19 PCB 61
PCB 20 PCB 62
PCB 21 PCB 63
PCB 22 PCB 64
PCB 23 PCB 65
PCB 24 PCB 66
PCB 25 PCB 67
PCB 26 PCB 68
PCB 27 PCB 69
PCB 28 PCB 70
PCB 29 PCB 71
PCB 30 PCB 72
PCB 31 PCB 73
PCB 32 PCB 74
PCB 33 PCB 75
PCB 34 PCB 76
PCB 35 PCB 77
PCB 36 PCB 78
PCB 37 PCB 79
PCB 38 PCB 80
PCB 39 PCB 81
PCB 40 PCB 82
PCB 41 PCB 83
PCB 42 PCB 84
PCB 43 PCB 85
PCB 44 PCB 86
PCB 45 PCB 87
PCB 46 PCB 88
PCB 47 PCB 89
PCB 48 PCB 90
PCB 49 PCB 91
PCB 50 PCB 92
PCB 51 PCB 93
PCB 52 PCB 94 PCB 53
DOH-1977 ( 1/26/2018 ) -3- ELAP Method No. ELAP Method No. Polychlorinated Biphenyls Polychlorinated Biphenyls PCB 136
PCB 95 PCB 137
PCB 96 PCB 138
PCB 97 PCB 139
PCB 98 PCB 140
PCB 99 PCB 141
PCB 100 PCB 142
PCB 101 PCB 143
PCB 102 PCB 144
PCB 103 PCB 145
PCB 104 PCB 146
PCB 105 PCB 147
PCB 106 PCB 148
PCB 107 PCB 149
PCB 108 PCB 150
PCB 109 PCB 151
PCB 110 PCB 152
PCB 111 PCB 153
PCB 112 PCB 154
PCB 113 PCB 155
PCB 114 PCB 156
PCB 115 PCB 157
PCB 116 PCB 158
PCB 117 PCB 159
PCB 118 PCB 160
PCB 119 PCB 161
PCB 120 PCB 162
PCB 121 PCB 163
PCB 122 PCB 164
PCB 123 PCB 165
PCB 124 PCB 166
PCB 125 PCB 167
PCB 126 PCB 168
PCB 127 PCB 169
PCB 128 PCB 170
PCB 129 PCB 171
PCB 130 PCB 172
PCB 131 PCB 173
PCB 132 PCB 174
PCB 133 PCB 175
PCB 134 PCB 176 PCB 135
DOH-1977 ( 1/26/2018 ) -4- ELAP Method No. ELAP Method No. Polynuclear Aromatic Hydrocarbons Polychlorinated Biphenyls Benzo(b)fluoranthene
PCB 177 Benzo(ghi)perylene
PCB 178 Benzo(k)fluoranthene
PCB 179 Chrysene
PCB 180 Dibenzo(a,j)acridine
PCB 181 Dibenzo(a,h)acridine
PCB 182 Dibenzo(a,h)anthracene
PCB 183 Dibenzo(a,e)pyrene
PCB 184 7,12-Dimethylbenzyl (a) anthracene
PCB 185 Fluoranthene
PCB 186 Fluorene
PCB 187 Indeno(1,2,3-cd)pyrene
PCB 188 3-Methylcholanthrene
PCB 189 Naphthalene
PCB 190 Phenanthrene
PCB 191 Pyrene PCB 192 Low Level Polynuclear Aromatic Hydrocarbons PCB 193 Acenaphthylene Low Level
PCB 194 Acenaphthene Low Level
PCB 195 Anthracene Low Level
PCB 196 Benzo(a)anthracene Low Level
PCB 197 Benzo(b)fluoranthene Low Level
PCB 198 Benzo(k)fluoranthene Low Level
PCB 199 Benzo(g,h,i)perylene Low Level
PCB 200 Benzo(a)pyrene Low Level
PCB 201 Chrysene Low Level
PCB 202 Dibenzo(a,h)anthracene Low Level
PCB 203 Fluoranthene Low Level
PCB 204 Fluorene Low Level
PCB 205 Indeno(1,2,3-cd)pyrene Low Level
PCB 206 Naphthalene Low Level
PCB 207 Phenanthrene Low Level
PCB 208 Pyrene Low Level
PCB 209 Priority Pollutant Phenols
PCB Congeners, Total 4-Chloro-3-methylphenol 2-Chlorophenol Polynuclear Aromatic Hydrocarbons 2-Acetylaminofluorene 2,4-Dichlorophenol
Acenaphthene 2,6-Dichlorophenol
Anthracene 2,4-Dimethylphenol
Acenaphthylene 2,4-Dinitrophenol
Benzo(a)anthracene 2-Methylphenol
Benzo(a)pyrene 3-Methylphenol
DOH-1977 ( 1/26/2018 ) -5- ELAP Method No. ELAP Method No. Volatile Halocarbons Priority Pollutant Phenols Carbon tetrachloride
4-Methylphenol Chloroethane
2-Methyl-4,6-dinitrophenol 2-Chloro-1,3-butadiene (Chloroprene)
2-Nitrophenol 2-Chloroethylvinyl ether
4-Nitrophenol Chloroform
Pentachlorophenol Chloromethane
Phenol cis-1,4-Dichloro-2-butene
2,3,4,6 Tetrachlorophenol trans-1,4-Dichloro-2-butene
2,4,6-Trichlorophenol 1,2-Dibromo-3-chloropropane
2,4,5-Trichlorophenol 1,2-Dibromoethane
Thiophenol 1,3-Dichloro-2-propanol
Volatile Aromatics 3-Chloropropene (Allyl chloride) 1,2,4-Trichlorobenzene, Volatile cis-1,3-Dichloropropene Benzene trans-1,3-Dichloropropene n-Butylbenzene Dibromochloromethane sec-Butylbenzene Dibromomethane tert-Butylbenzene Dichlorodifluoromethane Bromobenzene 1,1-Dichloroethane Chlorobenzene 1,2-Dichloroethane 2-Chlorotoluene 1,1-Dichloroethene 4-Chlorotoluene cis-1,2-Dichloroethene 1,2-Dichlorobenzene trans-1,2-Dichloroethene 1,3-Dichlorobenzene 1,1-Dichloropropene 1,4-Dichlorobenzene 1,2-Dichloropropane Ethyl benzene 1,3-Dichloropropane Isopropylbenzene 2,2-Dichloropropane p-Isopropyltoluene (P-Cymene) Hexachlorobutadiene, Volatile Naphthalene, Volatile Methylene chloride n-Propylbenzene Methyl iodide Toluene 1,1,1,2-Tetrachloroethane Total Xylenes 1,1,2,2-Tetrachloroethane m/p-Xylenes Tetrachloroethene o-Xylene 1,1,1-Trichloroethane 1,2,4-Trimethylbenzene 1,1,2-Trichloroethane 1,3,5-Trimethylbenzene Trichloroethene Styrene Trichlorofluoromethane Volatile Halocarbons 1,2,3-Trichloropropane Bromoacetone 1,1,2-Trichloro-1,2,2-Trifluoroethane Bromochloromethane Vinyl chloride Bromodichloromethane Chlorinated Hydrocarbon Pesticides Bromoform Aldrin Bromomethane Atrazine
DOH-1977 ( 1/26/2018 ) -6- ELAP Method No. ELAP Method No.
Chlorinated Hydrocarbon Pesticides Chlorophenoxy Acid Pesticides alpha-BHC Pentachlorophenol
beta-BHC Organophosphate Pesticides
delta-BHC Azinphos ethyl
Lindane Azinphos methyl
alpha-Chlordane Bolstar
gamma-Chlordane Carbophenothion
Chlordane Total Coumaphos
Chlorobenzilate Chlorpyriphos
2,4'-DDD (Mitotane) Chlorpyriphos methyl
4,4'-DDD Chlorphenvinphos
4,4'-DDE Crotoxyphos
4,4'-DDT Cyanizine
Diallate Demeton-O
Dieldrin Demeton-S
Endosulfan I Diazinon
Endosulfan II Dichlorfenthion
Endosulfan sulfate Dichlorvos
Endrin Dicrotophos
Endrin aldehyde Dimethoate
Endrin Ketone Dioxathion
Heptachlor Disulfoton
Heptachlor epoxide Ethion
Isodrin Ethoprop
Mirex EPN
Methoxychlor Famphur
Toxaphene Fenitrothion
Kepone Fensulfothion
Pentachloronitrobenzene Fenthion
Trifluralin Fonophos
Simazine Isophenphos Malathion Chlorophenoxy Acid Pesticides 2,4-DB Mevinphos
2,4-D Monocrotophos
2,4,5-T NALED
2,4,5-TP (Silvex) Parathion ethyl
Dicamba Parathion methyl
Dichloroprop Pendimethalin
Dinoseb Phorate
Dalapon Phosphamidon
MCPA Prometon
MCPP Prometryn
DOH-1977 ( 1/26/2018 ) -7- ELAP Method No. ELAP Method No.
Organophosphate Pesticides Benzidines Ronnel Benzidine
Sulfotepp 3,3'-Dichlorobenzidine
TEPP 3,3'-Dimethylbenzidine
Terbufos Volatile Organics
Thionazin Acetone
Tokuthion Acetonitrile
Trichlorfon Carbon Disulfide
Trichloronate Cyclohexane Di-ethyl ether Volatile Chlorinated Organics Benzyl chloride 1,4-Dioxane
Epichlorohydrin Ethyl Acetate
Miscellaneous Ethylene Glycol
Asbestos in Friable Material Isobutyl alcohol
Asbestos in Non-Friable Isopropanol Material-TEM Asbestos in Non-Friable Material-PLM 2-Hexanone
Asbestos-Vermiculite-Containing 2-Butanone (Methylethyl ketone) Materials Boron, Total Methyl acetate
Cyanide, Total Methyl cyclohexane
Cyanide, Free Methyl tert-butyl ether
Formaldehyde 4-Methyl-2-Pentanone
Lead in Paint n-Butanol
Lead in Dust Wipes 2-Nitropropane
Organic Carbon, Total Propionitrile
Perchlorate o-Toluidine
Phenols tert-butyl alcohol
Specific Conductance Vinyl acetate Sulfide (as S) Semi-Volatile Organics Extractable Organic Halides Acetophenone
Total Organic Halides 4-Amino biphenyl
Critical Agents Aramite
B. Anthracis, Swabs and Swipes Benzoic Acid
B. Anthracis, Powders, Fluids, Bulk Benzyl alcohol Mat. Botulinum Neurotoxin Benzaldehyde
Brucella 1,1'-Biphenyl
Burkholderia mallei Caprolactam
Burkholderia pseudomallei 1,2-Dichlorobenzene, Semi-volatile
F. tularensis 1,3-Dichlorobenzene, Semi-volatile
Orthopox 1,4-Dichlorobenzene, Semi-volatile
Ricin Toxin Dibenzofuran
Y. pestis Diethyl sulfate
Dihydrosafrole
DOH-1977 ( 1/26/2018 ) -8- ELAP Method No. ELAP Method No. Nitrosoamines Semi-Volatile Organics N-Nitrosodimethylamine
Ethyl methanesulfonate N-Nitrosodiethylamine
Isosafrole N-nitrosomethylethylamine
2-Methylnaphthalene N-Nitrosodi-n-butylamine
Methyl methanesulfonate N-Nitrosodi-n-propylamine
Phenacetin N-nitrosomorpholine
2-Picoline N-nitrosopiperidine
Piperonyl sulfoxide N-Nitrosopyrrolidine Resorcinol Minerals Safrole Bromide
Toluene Diisocyanate Chloride
O,O,O-Triethyl phosphorothioate Fluoride, Total
Amines Sulfate (as SO4) Aniline Nutrients o-Anisidine Nitrate (as N)
Carbazole Nitrite (as N)
2-Chloroaniline Orthophosphate (as P)
4-Chloroaniline Petroleum Hydrocarbons
4-Chloro-1,2-phenylenediamine Diesel Range Organics
4-Chloro-1,3-phenylenediamine Gasoline Range Organics
5-Chloro-2-methylaniline Oil and Grease Total Recoverable (HEM) a,a-Dimethylphenethylamine Dioxins and Furans 2,3,7,8-Tetrachlorodibenzofuran Diphenylamine 2,3,4,7,8-Pentachlorodibenzofuran 1-Naphthylamine 1,2,3,7,8-Pentachlorodibenzofuran 2-Naphthylamine 1,2,3,4,7,8-Hexachlorodibenzofuran 2-Nitroaniline 1,2,3,6,7,8-Hexachlorodibenzofuran 3-Nitroaniline 1,2,3,7,8,9-Hexachlorodibenzofuran 4-Nitroaniline 2,3,4,6,7,8-Hexachlorodibenzofuran 5-Nitro-o-toluidine 1,2,3,4,6,7,8-Heptachlorodibenzofuran Methapyrilene 1,2,3,4,7,8,9-Heptachlorodibenzofuran 4,4'-Methylenebis(2-chloroaniline) 1,2,3,4,6,7,8,9-Octachlorodibenzofuran 4,4'-Oxydianiline 2,3,7,8-Tetrachlorodibenzo-p-dioxin 1,4-Phenylenediamine 1,2,3,7,8-Pentachlorodibenzo-p-dioxin 1,2-Diphenylhydrazine 1,2,3,4,7,8-Hexachlorodibenzo-p-dioxin Pronamide 1,2,3,7,8,9-Hexachlorodibenzo-p-dioxin Carbamate Pesticides Aldicarb Sulfoxide 1,2,3,6,7,8-Hexachlorodibenzo-p-dioxin
Aldicarb 1,2,3,4,6,7,8-Heptachlorodibenzo-p-dioxin
Aldicarb Sulfone
Carbofuran
Nitrosoamines N-Nitrosodiphenylamine
DOH-1977 ( 1/26/2018 ) -9- ELAP Method No.
Dioxins and Furans 1,2,3,4,6,7,8,9-Octachlorodibenzo-p-dioxin
Are any of the additions or erasures requested on this form associated with State and/or Federal contracts? _____ yes _____ no I certify that the environmental laboratory analyses in the Solid and Hazardous Waste category for which approval has been requested are done using methods approved by the Commissioner of Health and that the information in this application is true to the best of my knowledge.
NAME OF LABORATORY DIRECTOR SIGNATURE OF LABORATORY DIRECTOR MO / DAY / YEAR
DOH-1977 ( 1/26/2018 ) -10-