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

z z o ■ WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD O i 1^ OF LABS & RESEARCH

SDG# ______________ . - LABORATORY WESTCHESTER COUNTY PAGE OF

■D o NAME l-A'h C o ADDRESS VALHALLA. NEW YORK CT o o CONTACT CONTACT o' Ca3 ■D —X SAMPLING ANALYSES o LABORATORY SAMPLE 3. TIME TYPE BNA PEST/ METALS CN 53^ #OF PRESER­ COMMENTS ffl> SAMPLE NO. SAMPLE NO. DATE VOA PCB Ta? BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS. ETC ) O O2-3b0 7 o o c 3 CD /*? 6>gf 9 4 / 42.

C>Z38Z / 2 row » i/S /

w DfJ 7 g <^2,3^5 t><P j>o 7

61 GI -y* 6*2-3 ^6 /Z7:xo / / O

^biZ\Z |/^3O^OZ.

//-- ANALYSES?tOMMENTS; I. SAMPl^D AND RELINC BY I. RECEIVE BY;- IV. RELINQUISHED. BY; IV. RECEIVED BY: ANALYSES/COMMENTS; SIGN ^SIGN: L, SIGN: SIGN; PRInT^^ A<t j PRINT; PRINT: FIRM; 7VM c ke-niiu FIRM; FIRM: “T^hiiioii^r^t DATE: TIME: DATE; TIME: II. RECEIVED BY: ANALYSES/COMMENTS; II. RELINQUISHED BY; 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;