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Chain of custody form, Westchester County Labs, Oct-Nov 2001

Machine-extracted title · confidence 100%

Chain of custody record for samples submitted to the Westchester County Department of Labs and Research.

NYC-WTC_000072603–000072610

Folder label: “25732

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Scanned page image, NYC-WTC_000072603
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OCR status: ok · source: pdftotext

2

§ WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD PAGE J OF t 1^ • co o OF LABS & RESEARCH o o LABORATORY WESTCHESTER COUNTY o O) O SDG# NAME CONTACT ADDRESS CONTACT VALHALLA, NEW YORK ____________________ I GO

LABORATORY SAMPLE NO. SAMPLE NO. DATE SAMPLING

TIME SAMPLE TYPE VOA BNA FeST/ PCB ANALYSES METALS CN BOTTLES PRESER­ VATION COMMENTS (SPECIAL INSTRUCTIONS, CAUTIONS, ETC) 'I fa, i f

izys-p

r ZoZH "T (ams

I, SAMPLELLAND RELINQ. BY I, RECEl ANALYSES/COMMENTS: IV. RELINQUISHED. BY; IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN>^==^-^=3^---- , • SIGN; SIGN: SIGN; PRINT: V' PRINT: PRINT: PRINT; FIRM: FIRM: FIRM: FIRM; i9/o,time: DATE; TIME; DATE: TIME;

II, RELINQUISHED BY: II. RECEl’ ;D 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 ^PLES TAMPERED WITH: NO YES N/A SAMPLES DISPOSED OF ON; IF YES EXpWi IN REMARKS BY:

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NYC-WTC_000072603Source: NYC Law Department, mirrored locally

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