Chain of custody record, Westchester County Dept of Labs, Jan

z o WESTCHESTER COUNTY DEPARTMENT OF LABS S RESEARCH ■

CHAIN OF CU PAGE i OF[ ■ill ■ o co

§o SDG# „ SO laboratory WESTCHESTER COUNJ'Y -D c I o NAME _ ADDRESS VALHALLA. NEW YORK o o o o o o CONTACT

LABORATORY SAMPLING nr

SAMPLE rn.i--viir CONTACT

PtST/i ANALYSES # OF PRtSER- COMMENTS I I CD JS- SAMPLE NO DATE TiME SAMPLE NO. TYPE VOA BNA PC0 METALS CN BOTTLES VATiON (SPECIAL INSTRUCTIONS, CA,UTIONS, ETC I

3 jlOBSsBwIIBilMIS 22225^

IIH 7-7..^sc j Tz ill *.•

(p J, i /2<.a3o^ ■ 57.5^0 .... ......... ; - ' L f -SSZ- itg l■^l ■

- ,

i SAMJ ANDRELINQ. SY ! ?^ECE| DBYi ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS; SIGN \ SIGN- SIGN: SIGN; PR»NT;^ J \ PRINT: PRINT; J FIRM; Y-00 FIRM: FIRM; DATE:^ ultimo Y.l A DATE; TIME: DATE; TIME:

11. RELINQUISHED BY: li. 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 !N REMARKS BY;