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A & L WESTERN AtLLABORATORIES, INC, <br /> 1311 Woodland Ave. #1 • Modesto,. California 9535'1 9.Phone 209-,529,4080 <br /> CHAIN OF CUSTODY t� <br /> Client—VIALL9 AiiioneIN <br /> Address- <br /> ft <br /> Signature of person authorizing work <br /> under terms staked below <br /> L -r <br /> Nei 30 days. All accounts past due wail be subject to interest char es of X.5% er m th. �: E• <br /> 'Hazardous materials are the property of the client. The client Is responsible for prop�lispos of hazardous wastes_Clients ndt '. <br /> picking up hazardous wastes may assessed an appropriate fee.. 4 4- <br /> PROJECT ID <br /> No. ANALYSIS <br /> of �► <br /> SA MP D BY: tore}; ars '' <br /> REMARKS wt <br /> sample <br /> type Sample Location <br /> Date Time ' <br /> --7---p <br /> - - -. -- - - <br /> !v X � <br /> low <br /> 6ia <br /> 1. <br /> ' - : T-- ' ° 4P" \' �._ bpi• ':}k '3.. <br /> - T. L _ - 4w rr <br /> Relin i hed by ore) Qte Time IlGeivday signature) # p8t Time <br /> Relinquished by(signature): Cate Time Received by(signature):, Dat Time <br /> Relinquished by(signature): - Date Time Received by(signature): _ -Da fimZCe <br /> ti <br /> r <br /> Relinquished by(signature): Date Time Received by(signature): Qate Time <br /> Relinquished by(signature): i Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Flours: Start; finish: Total Hours: <br /> Dedicated Exclusively to Provrdit1g Quality Analytical Services <br /> _ <br /> -E`4.-... <br />