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o WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o
i OF LABS & RESEARCH
LABORATORY WESTCHESTER COUNTY
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o NAME ADDRESS VALHALLA, NEW YORK CT
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o CONTACT yXorr'. s CONTACT _________________________
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SAM Tins'
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ANALYSES 3.
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ro LABORATORY SAMPLE PEST/ #OF PRESER COMMENTS 91
SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN c BOTTLES VATION (SPECIAL INSTRUCTIONS, CAUTIONS, ETC) O
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^377 07i£ (Pd-AVle. “T ZkZ o
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3
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^377 0T30 1
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I. RELINQ. BY I. RECEIVED BY; ANALYSES/COMMENTS; IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS;
SIGN;r,V'J. SIGN—fr^ SIGN: SIGN:
PRINT:b.v-', — PRINT: PRINT: PRINT;
FIRM.HVC-b^F’ FIRM: FIRM: FIRM:
DATE:^^O.3>ME:|^I< DATE:24^4 TIME;/j^ 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:
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