............. ............ ..... -_____ _ __________ ,4.
2
2
K
o WESTC) ER COUNTY DEPARTMENT CHAIN OF CUSTO@ RECORD -
O
co
3 OF LABS & RESEARCH PAGE_____ OF_____ —
o SDG#_________ _______________ _______ LABORATORY . WESTCHESTER COUNTY "0
1
o
o NAME Ce—stOo Lab ADDRESS VALHALLA. NEWYORK _ I
C
O
o
o
N
CONTACT DwMavv{ s CONTACT _ _______________________ •
T5!lll!illlllii====22211=0001110
ANALYSES . T I o
"0
o
N SAMPUNG I —
LABORATORY SAMPLE ?PESTL #OF PRESER- COMMENTS
W(e]‘iid, 0
SAMPLE NO. SAMPLE NO, DATE TIME TYPE VOA BNA PCB, METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS. ETC) o
o
CAT LePp —22238 0800 -• " 0 11 •
~~~ ki •
-—।I Q
C
ttmooocamtot.o wobooooootKoobouoB.cA.oSbgocoomproKes----- ms ===== moasseinsesmnensnsesreten 3
CD
61219013o1 0(4) JO I
0
/@o6H ) 1o3|ol 0920 lo
-I
l
i
1
t
I. SAM RELINQ. BY I. RECEI' ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS:
SIGN: W -5” SIGN: Gupe, 1 SIGN:
PRINT:b,w. byyso— PRINT: L
V
/'UC U Z PRINT:
FIRM:J-/c -D&P
DATE: i a/3) ol TIME:n<o
FIRM: L _ 7 FIRM:' FIRM: II
DATE/0 36(TMESC _6
---------- -——
DATE: TIME: DATE: TIME:
ANALYSES/COMMENTS: |
II. RELINQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY:
SIGN: SIGN: SIGN: SIGN:
PRINT: PRINT: fill PRINT:
595=== FIRM: PRINT:
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: _RT88 PRINT
PRINT: PRINT:
a FIRN
FIRM:
DATE: TIME:
FIRM:
DATE: TIME: nn DATE: TIME:
tm
FIRM;
DATE: TIME:: 1
—I '
EVIDENCE SAMPLES TAMPERED WITH:NO YES N/A SAMPLES DISPOSED OF ON:
=
IF YES EXPLAIN IN REMARKS BY:
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000027247Source: NYC Law Department, mirrored locally