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WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD PAGE___ L OF__ 1
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OF LABS & RESEARCH
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SDG# LABORATORY WESTCHESTER COUNTY
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CONTACT
SAMPLING
CONTACT ___________________ '
ANALYSES
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1. SAMPLED AND INQ. BY I. RECI ANALYSES/COMMENTS; IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS:
SIGN; SIGN: SIGN; SIGN:
PR*NT; PR’NT: , . ■ Cl PRINT; PRINT;
FIRM: FIRM: . FIRM: FIRM:
DATE: /mGf TIME: 'DATE: H ) TIME:^ DATE: TIME: DATE: TIME:
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:
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 EXPLAIN IN REMARKS BY:
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