z
■<
z o
o WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD co
PAGE OF
OF LABS & RESEARCH
■D
SDG# LABORATORY WESTCHESTER COUNTY I c
o ADDRESS VALHALLA, NEW YORK
o NAME o'
o CONTACT ________________
o CONTACT Y ■a
o
o SAMPLING ANALYSES 3.
KJ
GJ LABORATORY SAMPLE PEST/ #OF PRESER COMMENTS
GJ
SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS, ETC) 'So’
^5 7.7 □1142^ OW- ~T I 4
Ib
CD
2576 4^021 A I A
<^C.<a 6t-( ^577 <hi|oV Mill I 11
E&M 2777
I. GAMBLEDTfflD)RELINQ. BY I. RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS:
SIGN:?,.l^ SIGN:.<>r-2z SIGN: SIGN:
PRINT: PRINT; PRINT: PRINT:
FIRM.tJ-^C-^b^P FIRM; FIRM: FIRM:
DATE:^(,[o-i. TIME:|57o DATE^f%^TIME:^;^ 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:
OCR can misread numbers and units. Confirm readings against the page image before using them.