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Oa --d3 ► oo? <br /> a "A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-5294080 <br /> CHAIN OF CUSTODY <br /> Client G!/E NGV NSU T/6/4 Phone <br /> Address T • P-OX 3'794 CC to: <br /> CA zip 3 i9/ <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest char4/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 /> PROJECTID ANALYSIS <br /> No. <br /> i/2AL V LLE 6/✓IT/_".f /O of <br /> Con- <br /> SAMPL BY: (sl t re): taim <br /> ers <br /> REMARKS <br /> sa pie <br /> type Sample Location <br /> Date Time °,.b C—P <br /> — Q E <br /> 5 2 0 7 4 <br /> S E-�` 5 2 0 7 5 <br /> 1124 Sf / E—/2' 5 2 0 -705 <br /> 52077 <br /> l /1,75' X 1 1 WC-5r-- W / I 52078 <br /> VP-7—/b4 x - W-13 1 If 52079 <br /> Reli shed b i ure): Dae Time/ Received by(signature): Date Time <br /> /3 <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 /> 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 />