Chain of custody record, Westchester County Department of Labs

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WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o o CD OF LABS & RESEARCH PAGE OF

■D SDG# LABORATORY WESTCHESTER COUNTY c o NAME ADDRESS VALHALLA, NEW YORK CT o o' o CONTACT ; S' CONTACT _____________________________ o "0 o o SAMPLING ANALYSES ro 03 LABORATORY SAMPLE PEST/ #OF PRESER­ COMMENTS Oi SAMPLE NO. SAMPLE NO. DATE TIME , TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS, ETC ) O o Il /iT I a i Qyi\ ZZ7 I -HL Er . o c 'i-p ________ 3 o n/illoi Q'?4Q Ts 7 11 3

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I. eAWPtee-^^RELINQ. by I. RECEIVED BY: ANALYSES/COMMENTS; IV. RELINQUISHED. BY; IV. RECEIVED BY; ANALYSES/COMMENTS; SIGN:Z kJ. SIGN:'^.UAAiW SIGN: SIGN: PRINT: PRINT: PRINT: PRINT: FIRM: FIRM; ' " "'J' I FIZ-r FIRM; FIRM: DATE:h|mU| TIME:|4oO DATE; II |^/O)TIME:|4-PO DATE: TIME; DATE: TIME;

II. RELINQUISHED BY; 11. RECEIVED BY; ANALYSES/COMMENTS; V. RELINQUISHED BY; V. RECEIVED BY; ANALYSES/COM M ENTS; SIGN: SIGN: §IGN: 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: