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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_000072501–000072502

Folder label: “25495

Page image
Scanned page image, NYC-WTC_000072501
OCR text

OCR status: ocr · source: ours

L0SZZ0000 OLM-OAN yuUsWNDOq |BYOd II/4Nd LL/6 SAN wesTone a COUNTY DEPARTMENT CHAIN OF CUSTOD RECORD © OF LABS & RESEARCH PAGE re) SDG# LABORATORY _WESTCHESTER COUNTY NAME NYC -DEP ADDRESS VALHALLA, NEW YORK CONTACT _e~ Merv i & CONTACT SAMPLING ANALYSES LABORATORY SAMPLE PEST/ # OF PRESER- COMMENTS SAMPLE NO. [SAMPLE NO. DATE TIME TYPE VOA BNA {PCB {METALS|CN ; BOTTLES | VATION | (SPECIAL INSTRUCTIONS, CAUTIONS, ETC.) Cat Le SS4G) ihqio\ | 04921 | Vt ble VA 7 / lo EL VY 3 SuGh joatoll| Mes | Ata by A in A py. we CRO PESCIZIA polio | agBo | Potable Z an A 13 I. SAMPFED AND ELINQ. BY}1. RECEIVE aK) ANALYSES/COMMENTS: | IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: 1. Car SIGN: " ~ SIGN: SIGN: PRINT:D,w. Kabpj nse ~ PRINT: 2A | cle 4 PRINT: PRINT: FIRM: pyc -DE ‘FIRM: CS FIRM: FIRM: DATE: j6 ha Jo TIME: Bo | DATE: | dy} (TIME: )°34 DATE: TIME: DATE: TIME: 1 { v il. RELINQUISHED BY: Il. 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: Ill. 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 NIA SAMPLES DISPOSED OF ON: IF YES EXPLAIN IN REMARKS BY:

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NYC-WTC_000072501Source: NYC Law Department, mirrored locally

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