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e \ I <br /> A & L WESTERN LABORATORIES, I IV C. <br /> AtL 1311 Woodland Ave. #1 a Modesto, California 95351 • Phone 209-529-40SO <br /> CHAIN OF CUSTODY <br /> Client L t 4 `yf Phone <br /> Address___e-- - -2 CC to: <br /> { F:? zip 1 <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 /> VAI' VUR1e' /'-1 <br /> SAMPL taro- <br /> {' j <br /> sern ' <br /> r h REMARKS <br /> sample /JF <br /> type Sample Location <br /> Date Time Grab tomo <br /> l:Jr]u <br /> /m, X VA)RIV WrLil <br /> 4 <br /> r <br /> a ' <br /> i <br /> Rehe'd by sig re}: Date Time Received by ignature}; Date Time <br /> Relinquished by(signature); Date Time Received by(si ature): 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 />