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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 9 Modesto, California 95351 a Phone 209-529-4080 <br /> AUCCCCCUMUCIL <br /> CHAIN OF CUSTODY <br /> Client r i A) 1-�Z_7-//V;I, Phone 12 <br /> Address CC to: <br /> _7C L Lle- zip <br /> Signature of person authorizing work <br /> under terms stated below* <br /> 22 <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.7) ANALYSISl- <br /> / <br /> of <br /> V/11 lreCon- <br /> SAMP�L�BY. (sirtain- <br /> : ern <br /> REMARKS <br /> sample <br /> Dale Time type Sample Location <br /> 777 177- <br /> 7' <br /> _X <br /> sample <br /> 'y <br /> 11b <br /> Relinquish atur We Time Received by(signature): Date Time <br /> 7 f�54.D <br /> Relinquished by(sign `e): Date Time RecA lved 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 />