Laserfiche WebLink
_"... <br /> AtLA & L WESTERN LABORATORIES, INC. <br /> .1.311 Woodland Ave. #1 • Modesto, California 95351 • Phone 204529.4080 <br /> a9 r <br /> CHAIN OF CUSTODY C.384-8 <br /> " <br /> Client iAi �• L�PE5CARCi-� <br /> Address -- ' ( 1 <br /> CC to- <br /> - <br /> o <br /> ua i& s nm x „ <br /> Signature of person authorizing work <br /> under terms stated below, ; <br /> `Net 30 days. Ail accounts past due will be subject to interest char s of 1_,5% per month. <br /> "Hazardous materials are the property of the client. The client is f sponsible for proper disposal of hazardous wastes.�C(ients no. <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> :.}� ,dry.-.i #.:.• <br /> PROJECT 1D No. ANALYSIS <br /> L of t� r tilt <br /> Con- 7r t <br /> SAMP BY: (5i re): Iain- <br /> ars , REMARKS <br /> i - <br /> { z <br /> _sa pie 'Sample Location 'V <br /> Date Time <br /> Ow CMIR 7 <br /> 7 $ 5 AD <br /> NOR34 ev y '78 S TD'S R D .- =F <br /> . •: <br /> x <br /> c i <br /> Reli i ed by si ) t Time Receive b s' ure) i <br /> v , <br /> Relinquished by(signature} Date Time Received by(signature): � Dat LTi <br /> Relinquished by(signature) Date -Time Recelvedby(signature) $•Dat Time <br /> S <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> 1 <br /> Relinquished b (signature) Date Time Received b (signature).q Y Y( g ) Date ..,Time <br /> Site Time: ! Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> x D6dicate`d Exclusively to Providing Qlt�tl►ty Analytical Services ` <br />