Chain of custody record, Jan 2002

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'2 o o SDG# NAME LABORATORY WESTCHESTER COUNTY ADDRESS VALHALLA, NEW YORK C CT o' o CONTACT a CONTACT _________________________ ■D o Ca5 3. O sampling ANALYSES 03 cn SAMPLE o> LABORATORY PEST/ #OF PRESER^ COMMENTS o o SAMPLE NO. SAMPLE NQ, DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS, ETC.) o c 0«Q 4 I 4 3 CD

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BY I. RECE ■•// A ANALYSES/COMMENTS; IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN; SIGN: PRINT: p.vJ, PRINT: PRINT: PRINT; FIRM.jJVCL-bg.f’ FIRM: FIRM: FIRM; DATE:|[7^)q2.,T1ME:|C(5 q 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;