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A & L WESTERN LABORATORIES, INC. <br /> AtL 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> o <br /> CHAIN OF CUSTODY 2633 <br /> 1 <br /> Client EI i I ?n/ J�(SIKAI Phone f" 0 573 <br /> • t. <br /> Address �� .� Vfl C 1 rJ a CC to: <br /> tr Ylff L �VAIWa <br /> c,) S CA Zip <br /> /4944 11'14):Ve Wil y <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 /> '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 /> Con- <br /> SAMPLED BY: (signgWx@): tain- <br /> t �t ers REMARKS <br /> sample <br /> type Sample Location <br /> Date Time Grab caro. <br /> X v F <br /> fie Xv <br /> E <br /> Relinquished by(signasure):,� Date Time Received by(signature): Date Time <br /> RelinquNhed by(signaliire): Date Time Rssceived by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> i <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 /> ' I <br /> Dedicated Exclusively to Providing Quality Analytical Services Sec V, D 2— <br />