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- .,r,;., .,, - , .. .., ✓.of",� .4K ..-...,,,_.. , .. <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 2OM29-4080 <br /> CHAIN OF CUSTODY <br /> Client (-01VYG1/7-/6Z,� Phone <br /> AddressCC to: <br /> -rij D-1 04 lL L A Zip c-1 <br /> �r <br /> Signature of person authorizing work <br /> under terms stated below' <br /> *Net 30 days. All accounts past due will be subject to inters charges of 1.5% per month. <br /> I '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 NoANALYSIS <br /> lr d 7,C- e t Co <br /> SAMPLW BY: ( ' ature): tars <br /> r REMARKS <br /> sa ple <br /> Itype Sample Location <br /> Date Time a,ae <br /> I - I <br /> i N7— <br /> ZZ <br /> i <br /> i <br /> f <br /> L`f <br /> 1 <br /> ReI7 is ed by re): Date, Time ReEAivedfby(sign ture): Date Time <br /> 310 <br /> Relinquished by(signature): Date Time Re eived by(signature): Date Time <br /> w <br /> Relinquished by(signature): Date Time Received by(signature): Date 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 <br />