Chain of custody record, Westchester County Department of Labs &

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o ’ WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD co OF LABS & RESEARCH PAGE OF ■D SDG# __________________ LABORATORY WESTCHESTER COUNTY c o CT o name lOYc .^PgP ADDRESS VALHALLA, NEW YORK o' o o CONTACT CONTACT ■D cn o o _YSES 3. 03 03 LABORATORY SAMPLE PEST/ #OF PRESER- COMMENTS (SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC.) o o o “Sj _L_ 4- A c 3 CD 5 t H O

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T I I. OAMPL-CP ^jD RELINQ. BY I. REI BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN:P.lA>> SIGN SIGN: SIGN: PRINT:b.K 1 PRINT: /i!:. PRINT: PRINT; FIRM;NHe-&er FIRM: FIRM; FIRM: DATE: 5 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 S/MWIPLES DISPOSED OF ON:

IF YES EXPLAIN IN REMARKS BY;