Chain of custody record, Westchester County Labs, Oct 2001

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i; ■D SDG# LABORATORY WESTCHESTER COUNTY c CT NAME ADDRESS VALHALLA, NEW YORK o' CONTACT JL. rAbv ■< < < CONTACT _________________________ ■a o SAMPLING ANALYSES 3. 03 -‘t . : ‘ LABORATORY SAMPLE PEST/ #OF PRESER^ COMMENTS o 4 SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC.) o y lo|T-Zlo| Pgh.J>te^ 7 / io o c 3 CD ;■ I?' 6^00 7 7 l\ Vi I odO I I - SSt

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S' r ■ j ’7i 5 A I. SAMn ED At^^ELINQ. BY I. RECaiVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY; IV. RECEIVED BY: ANALYSES/COMMENTS: siGkvhUlWx' SIGN: SIGN: IS VP ’ FIRM; FIRM: l/i, PRINT; FIRM: PRINT: FIRM: DATE: ia^o| TIME: [5 )b DATE: Io 01 TIME; J'” DATE; TIME; DATE; TIME;

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

PRINT:' PRINT: PRINT; PRINT: FIRM: FIRM; FIRM: FIRM; I DATE:, TIME: DATE; TIME: DATE; TIME; DATE; TIME:

! '3 III.*-RELINQUISHED BY; III. RECEIVED BY: ANALYSES/COMMENTS; VI. RELINQUISHED BY: VI. RECEIVED BY: ANALYSES/COMMENTS:

fS ' a SIGN; PRINT;. FIRM: DATE; -L

. TIME: SIGN: PRINT: FIRM: DATE: TIME: SIGN: PRINT- FIRM; DATE: TIME: SIGN: PRINT; FIRM: DATE; TIME: ) ? Y- EVibENCE SAMPLES TAMPERED WITH: NO____ YES N/A SAMPLES DISPOSED OF ON: i.r •. . IF YES FXPI Ajjy remarks BY: _______