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Chain of custody record, Westchester County Department of Labs

Machine-extracted title · confidence 95%

Record documenting the chain of custody for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000070268–000070270

Folder label: “28229

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Scanned page image, NYC-WTC_000070268
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WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD * z PAGE( of / o si OF LABS & RESEARCH

SOG# LABORATORY WESTCHESTER COUNTY to

NAME ADDRESS VALHALLA YORK- “0 c CONTACT CONTACT CT o o' o SAMPLING ANALYSES "0 g LABORATORY SAMPLE PEST/ »Of PRESER­ COMMENTS o si o> : SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL instructions. CAUTIONS. ETC» 9L O oo . o H J o c 3 II £H iO'3^ 1^ " CD 3

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1. SAMPLED AND RELINQ. BY ANALYSES/COMMENTS: IV. RELINQUISHED. BY; IV. RECEIVED BY; ANALYSES/COMMENTS. SIGN: SIG^htW^^^ SIGN: SIGN: PRINT; PRINT: PRINT: PRINT: FIRM; , FIRM: WJU FIRM: FIRM; DATE; II TIME:' DATE: TIME; DATE; TIME:

II. RELINQUISHED.BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY; A^NALYSES/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; /XNALYSES/COMMENTS; VI. RELINQUISHED BY; VI. RECEIVED BY; ANALYSES/COMMENTS: SIGN; SIGN; SIGN; SIGN; PRINT; PRINT: PRINT: PRINT; I FIRM; FIRM; FIRM; FIRM: DATE: TIME: DATE: TIME: DATE; TIME; DATE; TIME: 1 EVIDENCE SAMPLES TAMPERED WITH:____NO____ YES____ N/A SAMPLES DISPOSED OF ON: ! 4 5 IF YES EXPLAIN IN REMARKS BY:

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NYC-WTC_000070268Source: NYC Law Department, mirrored locally

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