Chain of custody record, Jan 2002

z z o o WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD co OF LABS & RESEARCH PAGE OF

'2 ■D SDG# LABORATORY WESTCHESTER COUNTY c CT o NAME ADDRESS VALHALLA, NEW YORK o' o o CONTACT CONTACT _________________________ ■D o o o SAMPLING ANALYSES 3. 03 cn LABORATORY SAMPLE PEST/ #OF PRESER- COMMENTS SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS. ETC.) o o o CA-TLGfV^' “SIS 41 I 4- c 3 CD MUI 4- 1 /I l{Xg[0> IQSO 5 1 io K F6H

I. RELINQ. BY I. REGfElyEI ANALYSES/COMMENTS: IV. RELINQUISHED. BY; IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: Z IaJ SIGti SIGN; SIGN; PRINT:ti^,vJ. -- PRINT PRINT: PRINT: FIRM:ti4c-^^P FIRM: FIRM; FIRM: DATE.-! Zy(o^TIME:\^^5 DATE;, fS.j, 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;

111. RELINQUISHED BY: 111. 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: