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Chain of custody record, Westchester County Department of Labs

Machine-extracted title · confidence 95%

Record tracking the chain of custody for environmental samples submitted to the Westchester County laboratory.

NYC-WTC_000072168–000072175

Folder label: “26676

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Scanned page image, NYC-WTC_000072168
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Z. z WESTCHEMfcoUNTTDEPART^^ o 9. CHAIN OF CUSTOD' CORD co SS OF LABS & RESEARCH PAGE t OF I o! “0 'of SDG# LABORATORY WESTCHESTER COUNTY c CT §S NAME ADDRESS VALHALLA. NEW YORK o' CONTACT CONTACT "0 ro o o> SAMPLING ANALYSES 9L co, LABORATORY SAMPLE FEst/ #OF PRESER- COMMENTS O SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC ) o o c /0/^>/ /Of<T> 3 o 3

>1/ i iDsn ZDBa

771^ >-fD95X> 7.bb /ml 5''Z3ST3 TJJaSl. y 7/773

I. SAMPLED AND RELINQ. BY I. RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS; ---------- -r SIGN^*lLAL<Ul4^Lb—- SIGN: SIGN; PRINT: PRINT: PRINT: PRINT: FIRM: t?. FIRM; bfTL, J FIRM; FIRM: DATE: |o-5i-o,TIME: ■nME:fl90 DATE; TIME: DATE: TIME:

II. RELINQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES/COMMENTS: I SIGN; SIGN: SIGN; SIGN; i PRINT: FIRM: PRINT; FIRM; PRINT: FIRM: PRINT: 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:

I EVIDENCE SAMPLES TAMPERED WITH:____ NO YES N/A SAMPLES DISPOSED OF ON: 4 IF YES EXPLAIN IN REMARKS BY:

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NYC-WTC_000072168Source: NYC Law Department, mirrored locally

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