Laserfiche WebLink
;;, , , >• .,-. nam k _ , <br /> 4�•.,,� <br /> A & L WESTERN LABORATORIESs INC. <br /> 1311 Woodland Ave. #1 is Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> i t rc� / T�.,, lG® of <br /> Client �yE�/` E� (O n/ lz Phone <br /> Address �• i.�7 0 X CC to: <br /> 7ua c ocet CA zip ?f <br /> Signature of person authorizing work /!lli,. �iz�� �y <br /> under terms stated below' /�"" i"L <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 /> / SC TRAVEL (fENTEk' / c°o- <br /> SAMPLED Y: (sign e): <br /> tain- <br /> ers n�k REMARKS <br />+ sample <br /> type Sample Location So <br /> Date Time e,,, <br /> s 3v /L 70 //VX <br /> s?o 43f X 'CZ IAI I X <br /> 'y g FT l <br /> II 30 X Ix <br /> Reli u shed by ure): Bate Time Recei d by(signature): Date Time <br /> / / a <br /> X08 <br />•1111 Relinquished by(signature): Date Time Recd ved 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): Date Time <br /> If Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />