Chain of Custody Record, Sample AE03802, Feb 2002

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Z ■< o o to WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD g OF LABS & RESEARCH PAGE OF ■D 1^ c o SDG# _____________ ___ LABORATORY WESTCHESTER COUNTY o o' o o NAME ZEZZ5SZZ ADDRESS VALHALLA, NEW YORK "0 o CONTACT CONTACT _________________________ o CD 2 SAMPLING analyses LABORATORY SAMPLE PEST/ #OF PRESER­ O COMMENTS o SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN Sc BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC) o c 0152 ~T ___ U 3 o 3

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I. SAA4ELEE14NftRELINQ. BY I. RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGNi-^=r—- SIGN: SIGN: PRINT; PRINT: PRINT: PRINT: FIRM: FIRM; FIRM: FIRM: DATE:^v^|ot. DATE;x^/-^TIME;y; 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;