Chain of Custody Record, Sample AE06089, March 2002

Z Z ■<

o - o i WESTCHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD PAGE 1 OF t co

1^ OF LABS & RESEARCH. u c o o SDG# LABORATORY WESTCHESTER COUNTY CT o o' o NAME AJLA ADDRESS VALHALLA. NEW YORK "0 tn CONTACT CONTACT ____________________ o CD SAMPLING ANALYSES 9L LABORATORY SAMPLE PEST/ #0F PRESER­ comments O VATION o SAMPLE NO. SAMPLE NO. DATE TIME TYPE VOA BNA PCB METALS CN BOTTLES (SPECIAL INSTRUCTIONS, CAUTION!. ETC ) o c 3 o 3

n?>5'0 7771 ?JJI 10^

I Zj/ It 0778^ // -

07203 ^ej-SD 079 JI '^111 /oi.

FEk

I. SAMPLED ANDRELINQ. BY I. RECEIVED BY: ANALYSES/COM M ENTS: IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: SIGN: SIGN: SIGN; PRINT: 7^6 A PRINT; PRINT: FIRM: /iyc JPtT FIRM: FIRM; DATE: 3/i2/’c^i TIME: DATE: DATE; TIME; DATE; TIME;

II. RELINQUISHED BY: II. RECEIVED BY: , ANALYSES/COMMENTS: V. RELINQUISHED BY: V. RECEIVED BY: ANALYSES"/COMMEI )TS;^ SIGN: SIGN; SIGN: SIGN; PRINT; PRINT: PRINT: PRINT; FJRM: 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;