Chain of custody record, Sample AE 06050, March 2002

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o o WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD CD

OF LABS & RESEARCH PAGE OF ■D o o SDG# _________ LABORATORY WESTCHESTER COL mt c CT o o NAME ^0-- ADDRESS YALbAUA YORK o' CONTACT CONTACT ■D cn O cn SAMPLING _YSbS 3. cn 91 LABORATORY SAMPLE PEST/ ToF PRESER­ comments O SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTRES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC.) o o 07SO PcrkflVW I _E 11 c 3 I I CD hum JM y I I 3 O

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I. RELINQ. BY I. RECEIVED BY: ANALYSES/COMMENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN;rv^- SIGN:-^ SIGN: SIGN: PRINTD.VU PRINT: PRINT: PRINT: FIRM: FIRM; FIRM: FIRM: DATE:-^/,.f,2-TIME;|^ }« DATE^/y^ME:Xyp 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:

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: