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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 a Modesto, California 95351 a Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> r <br /> Client _ .L,� SN C�_ C.��l/S�L T//� ; Phone <br /> Address 1' a ' (�.� 3 79 CC to: <br /> Zip 5� .•,a l <br /> Signature of person authorizing work ' <br /> under terms stated below' 1 < <br /> t <br /> 'Net 30 days. All accounts past due will be subject to interest 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 /> SAMPLE Y: (si zture): tain. <br /> f ers REMARKS <br /> sample <br /> type Sample Location <br /> Date Time Grafi Comp. <br /> 2 f : U4 //770 WE,',r CLd E c X x Y <br /> !41 3U -7 <br /> Relir&shed btSsi`nature): Date Tire Received y(si ature): Date Time <br /> Z d14,L 'r b <br /> Relinquished by(signature): Date Time Received by(signature): ate Time <br /> I Relinquished by(signature): Date Time Received by(signature): Date Time <br /> f <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. Star(: Finish: Total Hours: <br /> 4 Dedicated Exclusively to Providing Quality Analytical Services <br />