Chain of custody record, Westchester County Labs, Nov 2001

z WESTCHESTER COUNTY DEPARTMENT CHAIN ! • OF CUSTODY RECORD o o OF LABS & RESEARCH PAGE__ Lof_ I § SD6# LABORATORY WESTCHESTER COUNTY

c -0 ADDRESS VALHALLA, YORK. c NAME CT o CONTACT CONTACT o' o ■0 o • sampling SSiiiiLYSES O LABORATORY SAMPLE 3. o tn PEST/ • OF PRE5EPP COMMENTS a> SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATIOM (SPECIAL INSTRUCTIONS. CAUTIONS. ETC) O CD o o c 3 CD O A —

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I. SAMPLE^D RELINQ. BY sign;*’*5^ - PRINT; V,TI<SlAo iSS^l^y PRINT: fl ! ANALYSES/COMMENTS: IV. RELINQUISHED. BY: SIGN: PRINT: IV. RECEIVED BY: SIGN: PRINT: ANALYSES/COMMENTS;

FIRM: FIRM: FIRM; FIRM: DATE: (|[(5jo|TIME:jf,^^ date: 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: ARM: ARM: DATE TIME: DATE: TIME: ' DATE TIME: DATE- TIME: III. REUNQUISHED BY: III. RECEIVED BY: ANALYSES/COMMENTS: VI. REUNQUISHEDBY: VL RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN; SIGN: SIGN: PRINT: PRINT: PRINT: PRINT: < FIRM: FIRM: FIRM; ARM: DATE TIME: DATE TIME DATE TIME DATE- TIME- EVIDENCE SAMPLES TAMPERED WITH:NO YES___ N/A SAMPLES DISPOSED OF ON: i! IF YES EXPLAIN IN REMARKS BY: