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WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD co
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s OF LABS & RESEARCH
SDG# LABORATORY WESTCHESTER COUNTY
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NAME
CONTACT
I ADDRESS
CONTACT
VALHALLA, NEW YORK
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ANALYSES
LABORATORY SAMPLE PEST/ #0F ^»>,| PRESER- 9L
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1. SAMPLED AND RELINQ. BY I. RECEIVED BY: f, ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS:
SIGN: SIGN: SIGN:
PRINT; PRINT: PRINT:
FIRM; , . X FIRM: IaM-i
VI _ U X FIRM: FIRM:
DATE: DATE:;^jq|g^TlME:)P> 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;
111. 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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