Chain of Custody Record, Sample AE03944, Feb 2002

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'2 SDG# NAME LABORATORY WESTCHESTER COUNTY ADDRESS VALHALLA. NEW YORK c o' § --4 CONTACT CONTACT _________________________ "0 o 4^ O O SAMPLING ANALYSES 00 LABORATORY SAMPLE PEST/ #OF PRESER­ COMMENTS O DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION o SAMPLE NO. SAMPLE NO. (SPECIAL INSTRUCTIONS. CAUTIONS. ETC ) o c 3 o 3

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o4 102^ i=i'^ I. RECEIVED BY: r ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN: PRINTS PRINT:/" PRINT: PRINT: FIRM: FIRM: U)V FIRM. FIRM: DATE:<^^i- 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: 111. 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: