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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client C7gj T F V c <JAl'L/; -�• � - Phone <br /> Address_f J X i I-d CC to: <br /> L 0 C it r /i"� zip . <br /> Signature of person authorizing work — <br /> under terms stated below' " �/ - -r <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 /> PROJECTID ANALYSIS <br /> of <br /> or <br /> Com <br /> SAMPL,°D BY: (signature): tain- <br /> ers <br /> REMARKS <br /> sample <br /> type Sample Location <br /> Date Time woo <br /> 1... :r y 921 8. _it-Fr, m, tit'n 1 >. <br /> 0i" Arglr ir.,,, <br /> Relinouished by(sigpiature): 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 /> 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 />