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:x». I.r,mn. a.v,... s ,:,� s.,w.acnM au':,�rrrrngnnee f'+ !�d? Y• �•I`g'im 7,17 <br /> A St WES?E�#N LABORATORIES, I'NO <br /> '181'''1 Woodland Aue #'1 •';Modesto, Cailforjjia 95351 . Phone 209-5294080 <br /> CHAIN Df .CUSTODY! <br /> Client . <br /> .f I l,:�t 4 . ' Phone 's <br /> Address CC t <br /> o <br /> zip <br /> Signature of.person''authohilho work . <br /> under terms..Mated below` '' <br /> 'Net 30 day$. All accounts past due will b@ su:bfect to anterest,ch ges of % per month, <br /> 'Ha ardous mateals are the property;%,of-the:�cl.lent.,.The client is res.ponsitile for pro.per:disposal of hazardous wastes. Clients not <br /> ri <br /> picking'up hazardous wastes:may,b'e assessed ari appropriate fee;'' <br /> PROJ ECT"I I3 Nc ,t1KALYSIS <br /> ' �f <br /> con A, <br /> 5AMPL rb)$Y (si n t' e) k tarn <br /> AJ <br /> ars REMARKS <br /> y ' <br /> same I . M. <br /> tYpe Sample LOeatibn § <br /> D';.te Time , <br /> AACj7 D ,� <br /> . .:.-.,. <br /> L: r <br /> v <br /> Rel qui ed by at Tir<ie Received,tiy signat.ure)i Date Time <br /> f <br /> Relinquished y(si:gnature): ate time Received'by(sigrfa uref: Date Time <br /> Relinqulshedby'{signature): Date` Time Receiue.dby(signature): Date Time <br /> Date" Time Recewed'b. st, nature Date Time <br /> a Relinquished by(s.i,gnatu.r.,e}: Y( 9 ); <br /> f ,. I , . . ...,.. .,. Date Time <br /> Relinquished by{signature};. Date.. T�rne Fteceived.by{signature): <br /> �rlVtn Time <br /> e Time: <br /> Start . Fi.t5h Total Hours; Start Finish. Total Hours; <br /> Dedicated EXcluslvely to pr"ourdrr g, duality Abalytical Services <br />