Chain of custody record, Westchester County Lab, Nov 2001

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zo WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o co OF LABS & RESEARCH PAGE OF § '2 ■0 SDG# LABORATORY WESTCHESTER COUNTY c CT o NAME tj'i c ADDRESS VALHALLA, NEW YORK o o' o CONTACT JL CONTACT _________________________ ■D o o SAMPLING ANALYSES 3. CD LABORATORY SAMPLE PEST/ #OF PRESER­ 91 O COMMENTS SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC ) O o o Z 4 H 4 ZZZIlZ3^Z^ZZ2ZZZZ c 3 CD n /i^joi o7S^ / lb__ k

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I. SAMgkgOiAWRELINQ. BY ANALYSES/COMMENTS: IV. RELINQUISHED. BY; IV. RECEIVED BY: ANALYSES/COMMENTS; SIGN:AZ7. SIGN: SIGN: PRINT: PRINT:yjvj^nU^ PRINT: PRINT: FIRM: FIRM: FIRM: PATE;,4.^|o;timE:(4z,^ DAT&S^/01TlME;Ji|^’^ 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/COM M ENTS: 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: