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Chain of custody record for Westchester County samples

Machine-extracted title · confidence 98%

Form recording the chain of custody for samples analyzed by Westchester County Department of Labs and Research.

NYC-WTC_000072420–000072423

Folder label: “25375

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Scanned page image, NYC-WTC_000072420
OCR text

OCR status: ocr · source: ours

027220000 OLM-DAN - tor “a — my sat Ot See - meetin! met everett oe yUSWNDOG |BEHOd I!NGNd 11/6 DAN ee —— iq mre r ~ E eran’ COUNTY DEPARTMENT CHAIN.OF.CUSTODY RECORD BS. BS.ERESEARCH a / PAGE___ OF. LABORATORY _WESTCHESTER COUNTY NAME. ‘Wye DE e ADDRESS VALHALLA, NEW YORK CONTACT ioe V\svcs s CONTACT erence SAMPLING ANALYSES y — Cok LABORATORY SAMPLE PEST/ #0F ~~ JTPRESER- COMMENTS SAMPLE:NO. | SAMPLE NO. _ | DATE TIME TYPE VOA {BNA |PCB METALS} CN BOTTLES | VATION | (SPECIAL INSTRUCTIONS, CAUTIONS, ETC.) J ATLELE Se ylulot | o44s | Peta ble A 7 7 yo oe oa Z (Wenig ~~ joiejoy | poro | Petable L£ Z| 12 eae : v : de ~ z fam uaterae soe - 4 ~ « Lp = RELING.-BY Te i] ANALYSES/COMMENTS: |IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: paren fe SIGN: SIGN: PRINT:.D;w, Relaass -- PRINT: PRINT: FIRM: Ryc-DE e i'l FIRM: “ FIRM: FIRM: DATE: tolye {0 | TIME:[ 41% DATE Nonime: te IS DATE: TIME: DATE: TIME: Il. RELINQUISHED BY: I. 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: IM. RELINQUISHED BY: "| Ill. 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: BY: a |i . JIRYES'EXPL REMARKS . mE eye eae y a x J

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NYC-WTC_000072420Source: NYC Law Department, mirrored locally

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