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Chain of Custody Record, Westchester County Lab, Mar 2002

Machine-extracted title · confidence 100%

Chain of custody documentation for environmental samples transferred to the Westchester County Department of Labs and Research in Valhalla.

NYC-WTC_000074828–000074833

Folder label: “AE 05231

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I z o WESTCHESI ER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD PAGE OF ! co OF LABS & RESEARCH Yo LABORATORY WESTCHESTER COUNTY f “0 c o SDG# CT o o NAME CONTACT ADDRESS CONTACT VALHALLA, NEW YORK _________________________ J o' "0 o ro SAMPLING ANALYSES oo ! 9L LABORATORY SAMPLE PEST/ #0F PRESER­ COMMENTS O

Yr.; TIME VOA BNA PCB METALS CN BOTTLES VATION

a SAMPLE, I. SAMPLENO. (SPECIAL INSTRUCTIONS, CAUTIONS, ETC) o o c 3 CD 3

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7 2Z I. SAMPI I. RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY; IV. RECEIVED BY; ANALYSES/COMMENTS; I. SIGN: U SIGN; SIGN: PRINT: PRINT: PRINT: FIRM; dat&j/^^time^ FIRM; FIRM; DATE; TIME: DATE: TIME; I t II. RELlfMoGlSHED BY: II. RECEIVED BY: ANALYSES/COMMENTS; V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES/COMMENTS: r SIGN: PRINT: SIGN: PRINT: SIGN; PRINT: SIGN: PRINT: I 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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NYC-WTC_000074828Source: NYC Law Department, mirrored locally

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Chain of custody record, Jan 2002 · Box DEP Box 62

NYC-WTC_000073037

Form documenting the custody chain for environmental samples submitted to the Westchester County Department of Labs.

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