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Chain of custody record, Westchester County Lab, Oct 2001

Machine-extracted title · confidence 95%

Document tracking the custody and handling of environmental samples submitted to the laboratory.

NYC-WTC_000027247–000027251

Folder label: “24233

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Scanned page image, NYC-WTC_000027247
OCR text

OCR status: ok · source: pdftotext

............. ............ ..... -_____ _ __________ ,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

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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:

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NYC-WTC_000027247Source: NYC Law Department, mirrored locally

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Westchester County Department of Labs and Research chain of custody form documenting the transfer of environmental samples.

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