Chain of custody record, Westchester County Labs, Oct 2001

z WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD I i o o OF LABS & RESEARCH

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■D o NAME C -bHr ADDRESS VALHALLA, NEW YORK c o CT CONTACT yAb/ J*; 5 CONTACT _________________________ o' 03 ■D OO SAMPCIRG ANALYSES o Ol LABORATORY SAMPLE PEST7 #OF PRESER­ COMMENTS 3. DATE TIME TYPE Qi 03 SAMPLE NO. SAMPLE NO. VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS, ETC) o 0^ ZTESuZ 4 ! -X_ 1 o o

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I. OAMPLED RELINQ. BY I. RECI iYj ANALYSES/COMMENTS; IV. RELINQUISHED. BY; IV. RECEIVED BY: ANALYSES/COMMENTS; SIGN; SIGN. SIGN: SIGN; PRINT:>.u>.fev-^^- PRINT: PRINT; FIRM.fJY'^'bFP FIRM; FIRM: FIRM: DATE: |(^3 tf>Z, TIME:(»< DATE: TIME; DATE; TIME;

11. RELINQUISHED BY: 11. 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:

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 SAMPLES TAMPERED WITH; NO YES N/A SAMPLES DISPOSED OF ON:

IF YES EXPLAIN IN REMARKS BY: