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Document / 9 pages

Chain of custody record, Westchester County Department of Labs &

Machine-extracted title · confidence 95%

Form documenting the chain of custody for samples submitted to or received from the Westchester County laboratory.

NYC-WTC_000075018–000075026

Folder label: “AE 05845

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Scanned page image, NYC-WTC_000075018
OCR text

OCR status: ok · source: pdftotext

-< Z ■< WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD PAGE 1 OF[ o ID o 05 LABS & RESEARCH g SDG# LABORATORY WESTCHESTER COUNTY "D c NAME ADDRESS VALHALLA. NEW YORK CT o CONTACT o' o CONTACT , __________________ o "0 o — IRI^f LYSES o LABORATORY S/iAAPLE a. tn o SAMPLE NO. SAMPLE NO. ■pmr TOP comments 9L DATE TIME TYPE VOA BNA PCS METALS ON BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS, ETC) O co o o S c *— 3 I 7 I I o 3

1 I I T

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I I. SAMPLED AND RELINQnBY I. RECEI’ kYi ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: P SIGN: SIGN; t PRiNT:^ t, PRINT: PRINT: ! FIRM: PIRM:-,/ / ! FIRM: DATE: y^^TiME://^ W ■tP TIME; DATE: TIME: i DATE:

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: TIME: DATE: TIME: DATE: TIME: DATE; TIME; DATE; ANALYSES/COMMENTS: VI. RELINQUISHED BY; VI. RECEIVED BY: ANALYSES/COMMENTS: III. RELINQUISHED BY: III. RECEIVED BY: SIGN: SIGN: SIGN; SIGN: i PRINT; PRINT: PRINT; PRINT: FIRM: FIRM: FIRM: FIRM: TIME: DATE: TIME: DATE; TIME: DATE: DATE; TIME; EVIDENCE SAMPLES TAMPERED WITH:NO___ YES N/A SAMPLES DISPOSED OF ON: BY: IF YES EXPLAIN IN REMARKS i 1

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NYC-WTC_000075018Source: NYC Law Department, mirrored locally

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