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Chain of custody form, Sep 2001

Machine-extracted title · confidence 85%

Record documenting sample transfer and custody for the Westchester County Department of Labs & Research.

NYC-WTC_000026055–000026063

Folder label: “22773 - 22779

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Scanned page image, NYC-WTC_000026055
OCR text

OCR status: ok · source: pdftotext

Z Z - - O WESTOSTER COUNTY DEPARTMENT CHAIN OF cusTOr RECORD O

2 OF LABS & RESEARCH PAGE OF CD —

1 o O O O O N CD RBG2—mortOWCRSRtab CONTACT U 7 SAMPLING LABORATORY ADDRESS CONTACT WESTCHESTER COUNTY VALHALLA. NEW YORK

ANALYSES "D C O o' "0 o O — o LABORATORY SAMPLE PESTI #OF PRESER- COMMENTS 0 o o SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC ) o Kx 3 VMMFAMEIEa Pezble Q C 3 -6x88 22774 9s CD

mitto 22776 9f7 24590 22776 33550 22777 4/5050 22778 % 55 3950 22779

1. SAMPLED AND RELINQ. BY L RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: = PRINT: V. It GO -—

FIRM: Qf C. 7 . , saA2A.. SIGN: PRINT: SIGN: PRINT:

DATE:(8leTIME: (o: :ssAte,timeaso FIRM: DATE: TIME: FIRM: DATE: TIME:

II. RELINQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN: SIGN: SIGN: PRINT: PRINT: PRINT: PRINT: FIRM: FIRM: FIRM: FIRM: DATE: TIME: DATE: TIME: DATE: TIME: DATE: TIME:

III. RELINQUISHED BY: III. RECEIVED BY: ANALYSES/COMMENTS: VI. RELINQUISHED BY: VI. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN: SIGN: SIGN: PRINT: PRINT: PRINT: PRINT: FIRM: FIRM: FIRM: FIRM: DATE: TIME: DATE: TIME: DATE: TIME: DATE: TIME:

EVIDENCE SAMPLES TAMPERED WITH: NO YES N/A SAMPLES DISPOSED OF ON:

IF YES EXPLAIN IN REMARKS BY: i

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NYC-WTC_000026055Source: NYC Law Department, mirrored locally

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