DEP WTC document fragment, Jan 2002

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O f ANALYSES LABORATORY PEST/ #OF PRESER- COMMENTS DATE' ? ¥ SAMPLE NO.; SAMPLE NO. BNA '5 PCB METALS CN BOTTLES VATION

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I. sampled'and relinq. by I. RECEIVED BY; ANALYSES/COMMENTS; IV, RELINQUISHED, BY; IV. RECEIVED BY; ANALYSES/COMMENTS: SIGN: SIGN:jfcfci7----- SIGN: SIGN; PRINTsT. H.v bG-*^A.<5 PRIN1 PRINT: PRINT: FIRM.OeF.^iS^ FIRM;L^ FIRM: FIRM: •S

DATEll'ZI TIME.<C>-A/^ DATE: DATE; TIME; DATE; TIME;

II. RELINQUISHED BY; II. 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: