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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-0080 <br /> CHAIN OF CUSTODY <br /> Client U66NEEi Phone <br /> n <br /> AddreCC to: <br /> TU I-zL©[ (L (A Zip 5-319/ <br /> i� <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to inters 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 /> GI ItS con- <br /> SAMPLEI� Y: (si nature): taim <br /> ers \ REMARKS <br /> sarnDis 1 C SC�Q\V <br /> rYP° Sample Location <br /> Date Time a.° C.P <br /> 3 90 WLF C I X I X I WE FA01 -I FL D <br /> 7 F 5 ' I X x <br /> '312 /aoo X K1 F /0 X <br /> 2 /uos X W C F 5 x <br /> 7 �� orS W4F 20 �C X X <br /> Re=d by i tureg Date. Time Re ived by(sl nature): Datf Time <br /> 3-% o /J r PSL d£> 1 i`;_-40 1)xD <br /> Relinquished/by(signature)/ <br /> elinquishe y(signature): Dale Time R eived 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 />