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r A, & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-�29080 <br /> 0 <br /> CHAIN OF CUSTODY <br /> ,. <br /> c Client �1�J�+r �C ,9/L✓I W r�/V� a Phone <br /> Address . O ' X 37 CC to: q <br /> .�.r2 LOCA. C.� , _Zips <br /> 4 Signature of person authorizing 4work <br /> under terms stated below" _ �&Z — <br /> 'Net 30 days. All accounts past due will-be subject to interest cha ges of 1.5% per month. <br /> "Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Glients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT,ID No. ANALYSIS Y <br /> :!!5 T/ . Con. �y <br /> SAMP . D BY: si nature): tarn <br /> ers Q' � REMARKS <br /> AARI <br /> sample V� m <br /> 'Ype Sample Location 1 <br /> Date Time Grah comV. f <br /> ' �zpt X 7 A t PI PJ D. l (. <br /> lPfrJF- 9 1 X <br /> J <br /> J <br /> Reli uished b ✓(s ure): Date Time ved by(signture}: Dat Time <br /> Relinquished by(signature): Date Timeeived by(signature): t Date Time <br /> JJJ � <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> 4 <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> u. <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />