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' A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529.4080 <br /> CHAIN OF CUSTODY <br /> Client__ 1__�f L� i t ( � j j� l j� Phone d Z 2. <br /> Address_ <br /> n CC to: <br /> Zip -7 <br /> t <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to intere 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 /> PROJECT ID No ANALYSIS <br /> of <br /> Con- Y <br /> SAMPgD BY- signature): <br /> twin-6)41 ers <br /> ` ,Ec REMARKS <br /> ample <br /> type Sample Location <br /> Date Time Grab comp. <br /> Relin u hed by ature): Dates Time Rved by(signature): <br /> Dat Time <br /> Relinquished y(signature): Date Time ecei ed y(signature): D tV Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): DateFTime <br /> Received by(signature): Date Time <br /> Relinquished by(signature): DateReceived by(signature): <br /> Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />