Waters, James D Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME: mift.Q. RETURN TIME: 1 5 Irk
f
DATE & TIME REMAINS ARRIVED AT CREMATORY: 1(171(lf 1-,WO
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS:
IttCSf 131,1k56
NAME: 31i vfd raC CASE # 11
TYPE OF CONTAINER: («vyg4J adobidd st-`(•‘4.1 14644 Mad
PLACE OF DEATH: tot R &vw43- 12 14 is 13 �., it f31
ESTIMATED WEIGHT OF REMAINS & CONTAINER 201 IJr r / 2 iLr
PLACED IN HOLD:
PLACED IN REFRIGERATION: 2'( ff 7
DATE OF CREMATION: OVA
TIME STARTED: 7 4D Kr1 TIME COMPLETED: /D4'°
PLACED IN RETORT: 7 's0 MOVED: S yS141- 11111
RETORT# IN WHICH REMAINS WERE CREMATED: S44Z- .14-iL9'r(
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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