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Chain of custody record, Sample AE06584, March 2002

Machine-extracted title · confidence 95%

Westchester County Department of Labs and Research chain of custody form for a water sample.

NYC-WTC_000075432–000075437

Folder label: “AE 06584

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OCR text

OCR status: ok · source: pdftotext

z Z WESTGHESTER COUNTY DEPARTMENT CHAIN OF CUSTODY RECORD o OF LABS & RESEARCH PAGE OF co

s o o " SDG#' ■" NAME - CONTACT LABORATORY WESTCHESTER COUNTY ADDRESS CONTACT VALHALLA, NEW YORK _________________________ “0 c CT o' o "0 cn SAMPLING ANALYSES o LABORATORY SAMPLE a. Ca5 PEST/ # OF PRESER­ COMMENTS 9L ro SAMPL^lXb. SAMPLE NO.. TIME TYPE/,> BNA PCB

-BE gE METALS CN BOTTLES VATION (SPECIAL INSTRUCTIONS. CAUTIONS. ETC ) O o o c 3 J__ CD 3

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7 I. SAIlJl#eB^^FBl)lCL BY I. RECI BY: ANALYSES/COMMENTS; IV. RELINQUISHED. BY: IV. RECEIVED BY: ANALYSES/COMMENTS: SIGN: < iIGN; / SIGN; SIGN: PRINT; PRINT: FIRM: FIRM: date: DATE: DATE: TIME: DATE: TIME: II. RELIl/qu/sHED 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:

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NYC-WTC_000075432Source: NYC Law Department, mirrored locally

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Chain of custody record, Jan 2002 · Box DEP Box 62

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Form documenting the custody chain for environmental samples submitted to the Westchester County Department of Labs.

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Document recording the custody chain and handling details for samples submitted to the Westchester County Department of Labs and Research.

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