Laserfiche WebLink
A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 e Modesto, Califomia 95351 a Phone 209-529-4080 <br /> •GtKuruu F+.'RWlMt wwateuF <br /> CHAIN OF CUSTODY <br /> 4 <br /> ClientL11-1,5� /l� 4 �C�/�llll[.T//t/�� Phone 4o <br /> 4 Address CC to: <br /> r/ —zip 5-s <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest/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 /> fl picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID No ANALYSIS <br /> 7wley con <br /> SAMPIrErD BY: mature): rain• �, F• <br /> s <br /> 1 ers A�Q ��� �y REMARKS <br />` gample <br /> A �� i <br /> Date Time 1ype Sample Location r t, <br /> Grab Comp. h <br /> CA NT r <br /> SI L� <br /> Relinq d by(sig t [fate Time Rec�iyed by(signature): Date Time <br /> / f ,c i <br /> i. V k_ <br /> Relinquished by(signature): Date Time Re.96ived by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> r <br /> Relinquished by(signature): Date Time Received by(signature): Date Time i <br /> E <br /> i <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 />