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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_000070332–000070335

Folder label: “28104

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Scanned page image, NYC-WTC_000070332
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OCR status: ok · source: pdftotext

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

■D I SDG# LABORATORY WESTCHESTER COLjJlT c o CT o ADDRESS VALHALLA, NEW YORK o NAME o' o CONTACT CONTACT ■D o o o sampling -YSES p- o 03 K3 LABORATORY SAMPLE PEST/ #OF PRESER- COMMENTS TIME TYPE BNA O SAMPLE NO. SAMPLE NO. DATE VOA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC ) o o c to I T 3 CD 4- <2 £5 «»6fe^o I Z6 10

I .ELINQ. BY 1. RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY; ANALYSES/COMMENTS; SIG^'3^2^'^ SIGNr-<'=*75r SIGN; SIGN: PRINT:J>.i^< « PRINTg^7^fe®>^ PRINT: PRINT: FIRM:aHC-I>^P FIRM; FIRM: FIRM: DATE;l»J|fiif TIME^Wb 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: /MMALYSES/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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NYC-WTC_000070332Source: NYC Law Department, mirrored locally

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NYC-WTC_000070276 · Box DEP Box 61

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

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