WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD * z
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SOG# LABORATORY WESTCHESTER COUNTY
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NAME ADDRESS VALHALLA YORK- “0
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CONTACT CONTACT CT
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SAMPLING ANALYSES "0
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SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL instructions. CAUTIONS. ETC» 9L
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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:
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EVIDENCE SAMPLES TAMPERED WITH:____NO____ YES____ N/A SAMPLES DISPOSED OF ON:
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4 5 IF YES EXPLAIN IN REMARKS BY:
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NYC-WTC_000070268Source: NYC Law Department, mirrored locally