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Chain of custody record, Westchester County Lab, Nov 2001

Machine-extracted title · confidence 90%

Chain of custody form for samples submitted to the Westchester County Department of Labs and Research in Valhalla, NY.

NYC-WTC_000070942–000070946

Folder label: “28859

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Scanned page image, NYC-WTC_000070942
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OCR status: ok · source: pdftotext

z z o o WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD co PAGE OF OF LABS & RESEARCH o LABORATORY WESTCHESTER COUNTY "0 o SDG# _____________ c CT o NAME ADDRESS VALHALLA, NEW YORK o o' CONTACT CONTACT _________________________ "0 o CD o SAM ’LIng ANALYSES KJ SAMPLE 03 LABORATORY PEST/ #OF PRESER­ COMMENTS SAMPL^I>1O. SA^L^r^O. TIME TYPE VOA SNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC) D o 3 I o c 2^2^522 —1__ 3 o -4 D— 3

HD

2z_ I. SAWO ;d BY I. RECEIVI ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN: SIGN: SIGN: PRINT: PRINT:L-C^ / PRINT: PRINT: FIRM: FIRM: FIRM: FIRM: DATE: TIME: DATE: TIME: II. RELIt^QCi'lSHED BY: ilreceivedby! ANALYSES/COM M ENTS: 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:

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NYC-WTC_000070942Source: NYC Law Department, mirrored locally

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