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--c i <br /> li 1 <br /> f <br /> A & L WESTERN LABORATORIES, INC. <br /> AtL 1311 Woodland Ave. #1 e Modesto, California 95351 • Phone 209-529-4080 <br /> @D S <br /> CHAIN OF CUSTODY f <br /> 4 2 <br /> Client L tr A4YLSEAkUJ- Phone - 140 <br /> o <br /> Address._ EBOX �� _ CC to: <br /> 1(_( R Z_CJ LI Z , CA zip If-3 e i <br /> Signature of person authorizing work ) <br /> under terms stated below* <br /> *Net 30 days.�Ail accounts past due will be subject to interest charges of 1.5% per month. <br /> *Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> i� i <br /> PROJECTID <br /> ` ANALYSIS <br /> of <br /> Con- <br /> SAMPLF6,,i BY: (signatjRp): tain- <br /> ers <br /> ;• REMARKS <br /> sample' <br /> ty"e Sample L cation g i <br /> Date Time Gran coma. <br /> I <br /> M <br /> r <br /> I <br /> Il <br /> 0 <br /> I <br /> RelingLihed by ature): Dpte7 Time Received by(signa re): Dale Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Dale Time <br /> Site Time: Driving Time: ; <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> l <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />