Garvilla Jr., Joseph B. Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4f1477 Or (518) 745-4476
FUNERAL HOME: W Ey _ RETURN TIME:
DATE A TIME REMAINS ARRIVED AT CREMATORY: Wftl b 7;IAFM
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS:
TONS) 1GEuY
NAME: owq CAev % (a CASED 7g
TYPE OF CONTAINER: }}�/F"—d G'✓1 YE1- P " 1"4 P
PLACE OF DEATHI 1 &dN & to-di /4wo1 1 '/ IrdT2
ESTIMATED MIGHT OF REMAINS 8 CONTAINER zw AY
PLACED IN HOLDI
PLACED IN REFRIGERATION: 31OrF1
DATE OF CREMATION: lIl 130 V1
TIME STARTED: 111DAllTIME COMPLETED: I�PI I �I
PLACED IN RETORT: 10D AM MOVED: I2ADPn) it-4Vh
RETORT R IN WHICH REMAINS WERE CREMATED: tom FR FAIL
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE; THE CREMATION LOG SHALL RE RETAINED IN THE PERMANENT FILE OF THE CREMATORY,
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