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Chain of custody form, Westchester County Labs

Machine-extracted title · confidence 90%

Document tracking the transfer and custody of samples received by Westchester County Department of Labs & Research.

NYC-WTC_000071898–000071905

Folder label: “26386

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Scanned page image, NYC-WTC_000071898
OCR text

OCR status: ok · source: pdftotext

z WESTCHE.^ COUNTY DEPARTMENT CHAIN OF CUSTODY CORD z ■<

o page/ o OF LABS & iWreARCH i 1^ SDG# LABORATORY WESTCHESTER COLmi! CD

o NAME ADDRESS VALHALLA, NEWYORK- “0 c o CONTACT CT o CONTACT o o' sampLiNG ANALYSES "0 LABORATORY SAMPLE PEST/ PRESER­ o 00 co TOF COMMENTS 00 SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS. ETC ) 9L O o o € c 1 L I I 3 o 3 I I

I__ L I

nk 1 ZZI_ (7 <2^

<=>

I. RECeiVHD BY: / ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: I. SAMPLED AND RELINQ. BY ANALYSES/COMMENT^ - SIGN:^ SIGN: SIGN: SIGN: PRINT^^'^ PR*NT:/T^yp PRINT; PRINT: FIRM: FIRM: FIRM: PATE: /,^^/ZTIME:A^>yT DATE: TIME: DATE; 4= DATEAcA-ctIoi TIME:1O'.9^ TIME: oc

II. RELINQUISHED BY: II. R/4.isir<q5i ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES/COMMENTS; SIGN; SIGN: SIGN: PRINT; FIRM; FIRM: 'b PRINT: FIRM; PRINT; FIRM: DATE: TIME: DATE: )TIME: 16 DATE: TIME: DATE: TIME: 1 III. RI lUlSJ JM. RECEIVED BY: ANALYSES/COMMENTS: VI. RELINQUISHED BY: VI. RECEIVED BY: ANALYSES/( OMM^TS:- SIGL. _ , . _ SIGN: SIGN: SIGN; 3 pRwin PRINT: PRINT- OO PRINT: -< - FIRM: X; FIRM; FIRM; FIRM; DATE: /a/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_000071898Source: NYC Law Department, mirrored locally

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