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i <br /> AL 'WESTERN LABOkATORIESs INC. <br /> AtL 1 311 Woodland Ave. #1 # Modesto, California 95351 9 Phone 20SZ294080 <br /> op <br /> CHAIN OF CUSTODY 2566 <br /> Client vv S-WAI Phone 5�}/ —0531 <br /> Address 9'6,3 L1, LEG1nLD_, E• cc to: 444foLa.GLG9c. <br /> 9ilis�_ e--,,f _ - zipCIS 354 14�f� Mo.vd �.✓ <br /> Signature of person authorizing worfc JdN eL�f . `js3�o <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 /> '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 lee. <br /> PROJECT 1D' Na ANALYSISJ <br /> Can � <br /> SAMPLED BY: (*)gnat a a• `� <br /> 7� REMARKS <br /> sample r <br /> I Data Time 4„p <br /> 1° Sample Location 7�\V <br /> s id oos Td—1 /U �C <br /> /� aZS —J-1 2S <br /> S/lo I 1 134 3.5 1 <br /> Shim/61 i <br /> t 6 Z5 X1 1 l —Z Z01 1 <br /> l41 <br /> S s'o ' <br /> Relin he {gnat re): A Date Time Received h ignature. Date Time <br /> Rellnqul hed try(signature): t T1r0i (a' a re): Dale Time <br /> /3. <br /> Relinquished by(sigriguray Da Time R ce nature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(Signature): Data T1me Received by(slgnalure): Date Time <br /> s . <br /> SlleTime: Driving Time: <br /> Start: Finish: Total}lours: Start: Firdsh: Total Hours: <br /> 9-- <br /> I <br /> s Oedicated Exclusively to Providing Quality Analytical Services <br /> r Sec V, D 1 <br /> I <br />