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w,�K•F��t �;;�.,�,;�;fix'".,V :�.. �, �.: - <br /> T <br /> AtLA & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> 'yNSu[ T/n/{ Phooe C� - I D <br /> Client r� <br /> Address P �'` ap�3 4 CC to: <br /> ( 1C(L <br /> ZiDqL 3 <br />' Signature of person authorizing work ����ii/lll �` Y q <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due.will be subject to interest cha es of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The client is esponsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may.be assessed an appropriate fee. <br /> f?ROJECT ID Na ANALYSIS <br /> 4 <br /> of .. <br /> Con. <br /> SAMP EDBY:: Iain- <br /> attire): ers �� <br /> REMARKS <br />` samp e <br /> type Sample Location <br /> Date Time Grab camp. / <br /> `i <br /> fk�, <br /> V4' <br /> jishe� egy(signatu <br /> atuy.�sre): DatTime R eived bignature}: Date Time <br /> 1124 <br /> Relinquishere}: Date Time 4ceived 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):r 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 />