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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_000070465–000070467

Folder label: “27678

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Scanned page image, NYC-WTC_000070465
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OCR status: ok · source: pdftotext

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WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o z PAGE co OF LABS & RESEARCH OF o SDG# LABORATORY WESTCHESTER C “0 c ADDRESS VALHALLA. I YORK. I NAME '2 o o CONTACT CONTACT o' "0 o o • SAMPLING ANALYSES 3. o LABORATORY SAMPLE TC5T7 TS' CD

o5 SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS. ETC) O o tn I o c a- 3 I T L 1 CD Z5

1

T T i

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I. SAMPLED^ REUNQ. BY I. RECEtVgB !Y: ANALYSES/COMMENTS: IV. REUNQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS; SIGNr—' SION: SION: SIGN: PRINT: VirifiCAsO RRM: A PRINT: LOA FIRM: Vf / r PRINT: FIRM: PRINT: FIRM: date fl-13-01 time If pate: time ((>5 DATE TIME: DATE TIME: II. REUNQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. REUNQUISHED BY; V. RECEIVED BY; ANALY8ESA:OMMENTS: I ■ SIGN; SION; SION: ^IGN: PRINT: PRINT; PRINT: PRINT: FIRM: FIRM; FIRM: FIRM; DATE TIME; DATE: TIME; DATE: TIME QATE TIME; III. REUNQUISHED BY: III. RECEIVED BY: ANALYSES/COEMTS: Vl. REUNQUISHED BY: Ml RECEIVED BY; ANALYSES/COMMENTS: SIGN: SIGN: SIGN: SIGN: PRINT: PRINT: PRINT: PRINT: FIRM: FIRM; FIRM; FIRM: DATE TIME DATE TIME DATE TIME DATE: TIME ”1

EVIDENCE SAMPLES TAMPERED VWTH: NO YES N/A SAMPLES DISPOSED OF ON: i

IF YES EXPLAIN IN REMARKS t BY: 1 ■

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NYC-WTC_000070465Source: NYC Law Department, mirrored locally

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