<
z WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD PAGE 1 OF(
o
CD
o OF LABS & RESEARCH
s SDG# LABORATORY WESTCHESTER COL -0
c
'2
o
NAME
CONTACT
ADDRESS
CONTACT
VALHALLA, YORK CT
o'
o
o
'□
O
—IRhVaM LYSES P.
cn LABORATORY SAMPLE PEST/ #OF PRESER- OS
o COMMENTS'
00 SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA SNA PCB METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUT ONS. ETC) O
o
o
c
a 3
o
3
I I I I I
)
I 1 5^11 I I 1
tgoIVLt br
I I I J I
\ 1 '^‘71^ 1 I I
F-feb
t
!
I.SAMF WD RgLINQ. BY I. RECQVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMW ENTS.
SIGN:^ SIGN:' SIGN: SIGN:
PRINT; PRINT: PRINT:
FIRM: ' A**- FIRM:Xv/^ J
i FIRM: FIRM:
DATE:3/<y/£?2 TIME/ft-of DATEy4;ZjlME:/^^ DATE: I TIME: DATE: TIME:
II. RELINQUISHED BY: II. RECEIVED BY: ANALYSES/COMMENTS: V. RELINQUISHED BY; V. RECEIVED BY: ANALYSES/COMIW ENTS:
SIGN; SIGN: i SIGN; SIGN;
PRINT: PRINT: I PRINT: PRINT:
FIRM: FIRM; i FIRM: FIRM:
DATE: TIME: DATE: TIME: i
i
DATE; j TIME; DATE; TIME:
III. REUNQUISHED BY: III. RECEIVED BY: ANALYSES/COMMENTS; VI. RELINQUISHED BY; VI. RECEIVED BY: ANALYSES/COMMENTS:
SIGN: SIGN: SIGN: SIGN:
PRINT; ( PRINT; PRINT;
PRINT: 1
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;
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000075087Source: NYC Law Department, mirrored locally