Laserfiche WebLink
A & L WESTERN LABORATORIES, INC. <br /> .M 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4.080 <br /> CHAIN OF CUSTODY <br /> Client./ Phone <br /> Address_ • e) - oQ,x -- —_ CC to: <br /> 'T—k zip <br /> Signature of person authorizing work <br /> under terms stated below` <br /> 'Net 30 days. All accounts past due will be subject to interest c rges 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 IDNa ANALYSIS <br /> ,L-c/2 nl, IZ Of <br /> Con- <br /> SAMPL BY: W(sire): tain.�� REMARKS <br /> sample <br /> ype <br /> Date Time Sample Location p Q <br /> Grab Comp. 1�, <br /> 117-4 J5'15~ , r j 9jV�Y L 4 AlE I X rtnlP F F�v.n S' 4rrPcE <br /> LZk 1-4&l5 3 <br /> Reit ui hed by{ re): D t Time Rec e by{ ignature Date Time <br /> AA <br /> elinquished y(signature): Date Time Rec ed by(signature): Date Time <br /> Relinquished by(signature): Dale Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Re{inquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time, Driving Time: <br /> Start: Finish: Totai Hours, Star(: Finish: Tata!Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />