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Chain of custody form, Westchester County Lab, Sep 2001

Machine-extracted title · confidence 95%

Record documenting the chain of custody for samples submitted to the Westchester County Department of Labs & Research in Valhalla.

NYC-WTC_000025692–000025696

Folder label: “22470 - 22496

Page image
Scanned page image, NYC-WTC_000025692
OCR text

OCR status: ok · source: pdftotext

•5*t 334 2 ***-**** ‘ , :4 043g* w A 2 _OF9E Gou r **. o K -t WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o 2 ‘ OF LABS & RESEARCH PAGE • - •1*7 trer

I o o SDG# NAME DJ) COE LABORATORY WESTCHESTER COUNTY ADDRESS VALHALLA. NEW YORK ianl * " 2 =1,* X MTK

o o o CONTACT TIH Mo££/G CONTACT ______________________ al 8 N CH O. CD ' : LABORATORY SAM PUNG SAMPLE ANALYSES PEST/ #OF PRESER- COMMENTS *arf 30A 43l d—r" 4 N SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA SNA PCB, METALS CN BOTTLES VATION . (SPECIAL INSTRUCTIONS, CAUTIONS, ETC.) *$10 222470 1,4 8 D&L/26965 CATLEFF- 645/ 3 hk -R ‘ , 3CD 3

. ** — -rAt +1. 4 . 55 aa* ta8"l 1'4570 "lot shathta • 4ye " . stosa w . R *p.* is Set rsmot sheleet’ Ratz " ** -* set s

ft - wiisous 2 5 *$3 - - 6E . - W ... - 95.77 vaav . : 2utd8g lar=jikiyiion=piz ----■--- ............ v SBD : taet 1. SAMPLED AND)RELINQ. BY 1.I. RECEIVED SY: BY: .. ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: t 7.6 : SIGN:7W Keewdr SIGN:, /awe- . SIGN: SIGN: 9 . / PRINTP, Kots a — PRINT: 5 < VA/ ACL t PRINT: PRINT: FIRM: C DP DATE:A4ol TIME: 2-36 FIRM: (- • 2 FIRM: FIRM: tk "4he DATEq/H/o(TIME(2:3 DATE: TIME: DATE: TIME:

11. RELINQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES/COMMENTS? "*=8: SIGN: PRINT: SIGN: PRINT: SIGN: PRINT: SIGN: PRINT: - (§ "*3 2 $4 Gteleg *** FIRM: DATE: TIME: FIRM: DATE: TIME: FIRM: DATE: TIME: FIRM: DATE: TIME: 28 t r L, se III. RELINQUISHED BY: 111. RECEIVED BY: ANALYSES/COMMENTS: VI. RELINQUISHED BY: VI. RECEIVED BY: ANALYSES/COMMENTS;; 5PR,! 11* SIGN: SIGN: SIGN: SIGN: . $ PRINT: PRINT: PRINT: PRINT: - fs FIRM: FIRM: FIRM: FIRM: d. A. ■ 38? r’ DATE: TIME: DATE:

EVIDENCE SAMPLES TAMPERED WITH: TIME: NO YES N/A DATE: TIME: SAMPLES DISPOSED OF ON: DATE: TIME: . ' aa e. otis yos . 44 4,640 g9"7 1

• t*r tah 1 IF YES EXPLAIN IMREMARKS

635 AW Y BY: (Oarss e

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NYC-WTC_000025692Source: NYC Law Department, mirrored locally

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