Wade Sr., Thomas Joseph Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(515) 745-4477 or (518) 745.4476
FUNERAL HOME: $Sf1,.-
- RETURN TIMe: _
DATE & TIME REMAINS ARRIVED AT CREMATORY;
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS;
--�-— �_,OASE R _
NAME:
AIL__
TVA! OF CONTAINER:
FLAGS OF DEATH:
ESTIMATED WEIGHT OF REMAINS & CONTAINER____— tRp
PLACED IN HOLD:
PLACED IN REFRIGERATION:
DATE OF CREMATION: gll)m
TIME STARTED __ _ LZL&0 M TIME COMPLETEDz Z,30fl
PLACED IN RETORT: L CD
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RETORT p IN WHICH REMAINS WERE CREMATED:
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 4a HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE: THE CREMATION LOG SHALL BE RETAINE. IN THE PERMANENT FILE OF THE CREP
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FIme View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME: TT N11 S
RETURN TIME .✓1w�DATE S TIME REMAINS ARRIVED AT CREMATORY:
NAME OF FUNERAL DIRECTOR OR REGRISTEREO RESIDENT OELIVFRI
le ztd!-k
NG REMAINS;
NAME: _ J
TYpE OF CONTAINER:
PLACE OF DEATH; _ uv
'kLe - ~
ESTIMATED WEIGHT OF REMAINS 8 CONTAINER_ ___
PLACED IN HOLD;
PLACED IN REFRIGERATION: _
DATE OF CREMATION:
TIME STARTED: COMPLETED: L _
PLACED IN RETORT: _
_MOVED: _�
RETORT# IN WHICH REMAINS WERE CREMATED: S✓fyT qy Z�- k
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED M00.�E THAN pE HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE: THE CREMATION LOG SHqu BE RETA:NES IS THE RERMANENT FILE OF TxE CREMATORY.