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At <br /> � A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-0080 <br /> CHAIN OF CUSTODY 03 q4 b "li <br /> Client ellAIC Phone <br /> Address P- , $42fic 3 794 -j CC to: <br /> I .V l:u 12C& rA Zip s <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest chap as 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 /> PROJECT ID No. <br /> ANALYSIS <br /> CGCS of <br /> Con- <br /> SAMP BY:tre : tain. <br /> srs REMARKS <br /> satSam a Location <br /> Date Time c..b <br /> Reli u' lied by ): D t Time R ei d y(signature): Time <br /> Relinquished by(signat ure): Date Time Re ivied by(signature): Dale Time <br /> Y <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 />