Kaplan-Angle Dana Edis (2) Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME: A&'EYApka RETURN TIME:
DATE & TIME REMAINS ARRIVED AT CREMATORY: yhgjj //:OUv
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS:
NAME: PAM PAW " Oaf CASE # 391
TYPE OF CONTAINER: 60910 ��K�-r �• �r'4� ���i°�Ko'
PLACE OF DEATH: Roljoy4 - 51ATJ Rc l G 5 U re, L.14,,j f� (Ac_
ESTIMATED WEIGHT OF REMAINS & CONTAINER Ns
PLACED IN HOLD: Ildc Ml
PLACED IN REFRIGERATION:
DATE OF CREMATION: q l?j l z l
TIME STARTED: -7 '4010 TIME COMPLETED: 2'�
PLACED IN RETORT: 7-15-0 ,_MOVED: S ! i�1 y sl�fil l
RETORT# IN WHICH REMAINS WERE CREMATED: Suff(, fowElt.: fAV
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE:THE CREMATION LOG SHALL BE RETAINED IN THE PERMANENT FILE OF THE CREMATORY.
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NY 12885
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