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A & L WESTERN LABORATORIES, INC. :. <br /> AtL 131._1 Woodland Ave. #11 • Modesto, California 95351' e-Phone 209-529,4080 <br /> _ ® <br /> CHAIN OF CUSTODY <br /> 3737 <br /> .- <br /> CII / r - <br /> ent— Phone f�+� .w <br /> Address CC <br /> rni _ <br /> Signature of person authorizing work <br /> under terms stated below' 1 <br /> 3 <br /> e- <br /> Net 30 days. All accounts past due will be subject to interest chs es of 1.5% per � <br /> 'Hazardous materials are the.property of the client: The client is responsible for pro disp of hazardous wastes. Clients not �• _ <br /> picking up hazardous wastes may be assessed an appropriate fee, <br /> PROJECT 117 ANALYSIS (( A r <br /> Con. " <br /> SAMPL BY: (sig ure): twin- <br /> REMARKS 1 <br /> sample1� <br /> type Sample Location <br /> Date Time <br /> 1311bCom O. .. -- <br /> dv L 503 57 <br /> ,�_ :41 <br /> ��� 2f x L // x 5 4 3 5 <br /> `J <br /> Relin hed by ture): Date Time Received y( to ): Date : Time <br /> g, I <br /> Relinquished 6y(signature). - Date Time Received b ( " nature): ate! Time <br /> #` <br /> Relinquished by(signature): Date Time Received by(signature): Date: i 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 /> Dedicated Exclusively to Providing Quality Analytical Services i <br />