-< CHAIN OF CUSTODY RECORD o
o WESTCHESTER COUNTY DEPARTMENT
PAGE l OF I co
g OF LABS & RESEARCH
o SDG# LABORATORY WESTCHESTER COUNTY “0
I c
o ADDRESS VALHALLA, NEW YORK- CT
o NAME
o o'
o CONTACT CONTACT ______________________
"0
o
KJ • SAMPLING ANALYSES
C3>
cn . LABORATORY SAMPLE PEST/ FOF PRESER COMMENTS 9L
SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC) O
o
o
c
S3 TTt^ 3
CD
^onX 4- 3
r r J-non q
0^40
0
12.
nos
7
ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS:
SIGN: SIGN:
PRINT: S. PRINT: Dfiry] n PRINT: PRINT:
FIRM: FIRM: 4 FIRM: FIRM:
DATE; 11/3/01 TIME: DATE: y/5/i?i TIME:y|:^ DATE: TIME: DATE: TIME:
J
II. RELINQUISHED BY: II. RECEIVED BY; ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES/COMMENTS:
SIGN. SIGN; SIGN: SIGN;
PRINT: PRINT: PRINT: PRINT:
I
FIRM: FIRM: FIRM: FIRM:
i TIME: DATE: TIME: DATE: TIME: DATE: TIME:
DATE:
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:
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000071265Source: NYC Law Department, mirrored locally