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111,40 7'S ._ :-.. .,. ..,�.... w v......,...:.._. ..e�,paV:. -..- .. <br /> A & L WESTERN LABORATORIESs INC. <br /> 1311 Woodland Ave. #1 a Modesto, California 95351 a Phone 209-529-3080 <br /> CHAIN OF CUSTODY <br /> ClientC1� C0IVJU17-1/"W Phone 4i/o 0- 14 c' <br /> Address P e 30 u 7 7q-4 CC to: <br /> TLS R LC LL -/I zip 95201 <br /> Signature of person authorizing work ; <br /> under terms stated below' <br /> -Net 30 days. All accounts past due will be subject to Interest ch es 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 /> of SF <br /> Con. <br /> SAM D 6Y: nature): ers } <br /> REMARKS <br /> s a <br /> A, <br /> �rw Sample Location 1. ` <br /> Date Time )� <br /> am curio. <br /> x x <br /> i` Idol \ Z IAI I <br /> Reil uished by ature): to Time R ad by(sl p iature): Date Time <br /> J° v7 I9'rS C 7. <br /> Relinquished y(signature): Date Time R�ceived 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 /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />