Chain of custody record, Westchester County Department of Labs

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Z { WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o PAGE I OF 1 co o 1 OF LABS & RESEARCH

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'2 O ; NAME CONTACT CONTACT CT o' "D O 1 o • SAMPLING ANALYSES o p. o i LABORATORY SAMPLE PtsiT TOF Preser­ comments o> SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES vation O cn (SPECIAL INSTHUCTKIWS. CAUTIONS. ETC) o K) o Tits. c 3 CD

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ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS; SIGN.-^ Z?f SIGN; SIGN: PRINT;-S-rApuf, PRINT: fc- PRINT: PRINT: FIRM: FIRM; FIRM: FIRM: DATE: 11/I 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: ANALYSES/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;