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WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD y o
2 OF LABS & RESEARCH ______ _____ 2- 6 70 - 0 070
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NAME DgCDIP
LABORATORY
ADDRESS
WESTCHESTER COUNTY
VALHALLA. NEW YORK
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N CONTACT CONTACT
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SAMPLE NO. SAMPLE NO. DATE
SAML LING
TIME
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TYPE VOA BNA
PEST/
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ANALYSES
METALS CN
PRESER-
954 BOTTLES VATION COMMENTS
(SPECIAL INSTRUCTIONS, CAUTIONS. ETC.)
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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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