Chain of Custody Record, Sample AE03384, Feb 2002

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c o o o SDG# NAME CONTACT ________________ LABORATORY ADDRESS CONTACT WESTCHESTER COUNTY VALHALLA. NEW YORK _________________________ “0 c CT o' "0 Ca5 SAMPLING ANALYSES o O> LABORATORY SAMPLE Ca5 PEST/ # OF PRESER­ COMMENTS 9L CD SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA SNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS, ETC ) O I o A o c 3 (3^ Qi A i 4 o 3

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ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN; PRINT;^^- print:<(:AUSihS’V PRINT: PRINT: FlRM;?AY6:-'t>&f’ If IRM; UvL-. ,^0 FIRM; FIRM; DATE:a(n|o-X. 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;