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ETAtLA & L WESTERN LABORATORIES, INC, <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> o <br /> CHAIN OF CUSTODY <br /> Client -VA V A0 K-'�':r A Phone �'�G�_ �40 3 <br /> Address —� CC to: <br /> L( AWeJ4. GSE zip �? ' <br /> Signature of person authorizing work <br /> under terms stated below" <br /> ,F <br /> 'Net 30 days. All 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 /> II <br /> PROJECT ID No. ANALYSIS <br /> k0A1 PfJt�`IFO Co- <br /> tain- <br /> SAMPLED BY: (saflre): ers <br /> REMARKS <br /> Xuh. <br /> sample f\ <br /> type Sample Location <br /> Date Time Grab ICO-P.1 <br /> IVA i=rZ. Tib 6 L E II x `A.SE —rr -5,P D /-I Nr <br /> :s • <br /> li <br /> Relinquished bY <br /> gnafure}: Date Time Receiyed by(signature): Date Time <br /> r, <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): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> i <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />