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„ < ...na.�,9r-. . .�.;�a n,. stit(rPZ"'uw•...:..., ...'r .. -.«.::.. N. ...,....ee�!ainn...-..mwpM1SNe,�*36`R'S:'iV`l'!n"'H�S r0hrr�':.”°'tib-re a.mg«r.,.-r, - . <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-1080 <br /> CHAIN OF CUSTODY <br /> i <br /> Client (FiE StirE C On/5cr L r1 v6 Phone <br /> P. v Box -7D-7,1 � <br /> AddressCC to: <br /> 'rL( fZLUGk . C<l zip 943� r <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. 1 <br /> PROJECT ID No ANALYSIS q 4i <br /> KSC TRAVEL CFivTEe o r t <br /> Com <br /> SAMPLEY: (sirtt;ye): ars• J N <br /> GI u�'r-�� ers F� J (I f\� REMARKS <br /> sample f, y <br /> Date Timetype Sample Location <br /> tom ��Pi Qk kI Z\�r Q Oil <br /> p w o. <br /> 77 iaov x 6lAe r1ry WV/TP 2 X X1 X1 X1 X X1 u <br /> f <br /> Relin gate Time Received by(signature): Date Time <br /> 1e og <br /> 0910/ <br /> Relinquished by(signature): Date Time ReWeived by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> I <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signalure): 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 />