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Chain of custody record, Westchester County Labs

Machine-extracted title · confidence 85%

Document recording the chain of custody for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000071360–000071363

Folder label: “27110

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Scanned page image, NYC-WTC_000071360
OCR text

OCR status: ok · source: pdftotext

Z z WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o co OF LABS & RESEARCH PAGE OF

'2 o o SDG# NAME LABORATORY WESTCHESTER COUNTY ADDRESS VALHALLA, NEW YORK “0 C CT o' o CONTACT CONTACT _________________________ "0 o o SAMPLING ANALYSES CD LABORATORY SAMPLE PEST/ #OF PRESER­ 9L O COMMENTS SAMPLE NO. SAMPLE NO. date. TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC.) O o |i(g|o) ZZZjZKW / 4 ~Z t --- U— o c 3 o Wk 74 7^ Bi. 3

6^0 |o\ nil olZW zs / 6 Z3 n

I. SAMPLED ANDjRELINQ. BY I. RECEIVI ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: Z SIGN: SIGN: SIGN; PRINT: PRINT; PRINT; PRINT; FIRM; FIRM: FIRM: FIRM; DATE; 11 /So) TIME^7.,a 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: 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:

YES EXPLAIN IN REMARKS BY:

*

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NYC-WTC_000071360Source: NYC Law Department, mirrored locally

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NYC-WTC_000070942 · Box DEP Box 61

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

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