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Document / 8 pages

Chain of custody record, Westchester County Labs, Oct 2001

Machine-extracted title · confidence 90%

Document tracking the transfer of environmental samples to the Westchester County Department of Labs and Research.

NYC-WTC_000027723–000027730

Folder label: “24872

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Scanned page image, NYC-WTC_000027723
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2 : 2 - - O WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD y o 2 OF LABS & RESEARCH ______ _____ 2- 6 70 - 0 070 PAGE ( OF CD — o I O O O SDG# NAME DgCDIP LABORATORY ADDRESS WESTCHESTER COUNTY VALHALLA. NEW YORK e O O o' N CONTACT CONTACT N OO LABORATORY SAMPLE NO. SAMPLE NO. DATE SAML LING TIME SAMPLE TYPE VOA BNA PEST/ PCB ANALYSES

METALS CN PRESER- 954 BOTTLES VATION COMMENTS (SPECIAL INSTRUCTIONS, CAUTIONS. ETC.) I &

Bx3 M%‘2 lorn /0,00— g 8158 G NNWMHEEK 707so 30804 (ofo 0843 20450 31750 att /O/o toito 30322 JM(J/DHKLri Oo17 1130

50250 10/0 1157 2499 I. SAMPLED AND RELINQ. BY 1. RECEIVED B SIGN----l • f PRINT: V.TIGCAo FIRM: O.E.P SIGN:A PRINTLoAVe FIRM: WrK DATE: [o(n//TIME: I25 DATFionoi 3K ANALYSES/COMMENTS: IV. RELINQUISHED. BY: SIGN: PRINT: FIRM: DATE: TIME: IV. RECEIVED BY: SIGN: PRINT: FIRM: DATE: TIME: ANALYSES/COMMENTS:

i 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: i 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 EXPLAG REMARKS BY:

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NYC-WTC_000027723Source: NYC Law Department, mirrored locally

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NYC-WTC_000026432 · Box DEP Box 19

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

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