Chain of custody record, Westchester County Lab, Sep 2001

2 2 K WESTCI R COUNTY DEPARTMENT CHAIN OF CUSTOO.CORD W 4 OF / K O O 2 OF LABI RESEARCH PAGE 7 h :i ** 99 CD — o SDG# _______ ___ LABORATORY WESTCHESTER COUNTY 1 o o NAME NYCP6/BWS Kensicolob - ADDRESS VALHALLA, NEW YORK "0 C O o CONTACT_____________________ CONTACT ____________ _________ o' o N “0 O. —SAMPLING _ ANALYSES #OF o CH et LABORATORY SAMPLE 059 PRESER- COMMENTS~ — C SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA L BNA pcB" METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS, ETC.) 0 o Zoll) TV £t. 3422364 2636 o o C 3 CD Do( 18 /49 )

CQ06/ 3344 2/236

___ -nm I. SAMPLED AND RELINQ, BY 1. RECEIVED BY? ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: P.l, 6-m— SIGN: Nel SIGN: SIGN: ) PRINTS. w, Pabirsc FIRMWSC EP PRNTLesPe 9. DATE:24loi TMEOGos DATE:S))9,TMEC!/) PRINT: FIRM: PRINT: FIRM: TIME: Si :" 3 — Li m

DATE: TIME DATE: _____________________ II. RELINQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: wet AISHEDBY: V. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN: SIGN: SIGN: PRINT: PRINT: PRINT: PRINT: 7 FIRM: FIRM-U FIRM: 00 FIRM: DATE: TIME: DATE TIME DATE: TIME: DATE- TIME: ANALYSES/COMMENTS 1 ill. RELINQUISHED BY: III. RECEIVED BY: ANALYSES/COMMENTS: VI. RELINQUISHED BY: VI. RECEIVED BY- SIGN: SIGN: : SIGN: SIGN: PRINT: 55 r

PRINT: PRINT: PRINT: l FIRM: FIRM: : FIRM: FIRM: ■

DATE: TIME: DATE: TIME: DATE.TME: __________________ DATE- TIME: I ....... ICE SAMPL 3ED WITH’ Nio YES N/A SAMPLES DISPOSED OF ON: 7 BY:’ IN KEMARKS