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AtL <br /> A & L WESTERN LABO ATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> 0 <br /> CHAIN OF CUSTODY <br /> - <br /> client lr � 1V� '(3/ j L�(, //�[ one <br /> � � � ? Ph, <br /> Address_ <br /> P d g4 �7 q GG to: <br /> Cit zip1 & XVJ <br /> '& t . <br /> Signature of person authorizing work € <br /> under terms stated below' t <br /> 'Net 30 days. All accounts past due will be subject to interest chd es of 1.5% per month. <br /> `Hazardous materials are the property of the client. The client is,'.responsible for proper disposal of hazardous V�Kste lients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID No. ANALYSIS <br /> ,2/IVAu2C <br /> 0 °t <br /> on- <br /> SAMED BY: ture): tain- � <br /> ers REMARKS <br /> ample' I <br /> Hype Sa ple Location L� <br /> Date Time <br /> i, <br /> S Z <br /> 7� `t- - <br /> 5a L r+ <br /> Reli i hed by re): D to Time Re c d y(s(gnat rrle): Date Time <br /> { <br /> Relinquished y(signature): Date Time,, Rece` ed by(signature): Dat Time <br /> Relinquished by(signature): . Date Time` Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signatuiFe)" .' "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 />