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5. <br /> �= A & L WESTERN LABORATORIES, INC. <br /> ♦TSL" 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client LA-SIUfV C0/U5YZ7-1AJ11 Phone �Oa- IloS 2- <br /> Address <br /> Address /:7. ,) is Q< 3 7 ' " CC to: <br /> i aRc.oeV, OA zip <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days.All accounts past due will be subject to intere 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 /> S0 k 7-q 11V I Al) 5 of F <br /> Con <br /> SAMP D BY: ature): ern ��I� REMARKS <br /> sample t <br /> Ivpe Sample Location <br /> Date Time <br /> ✓3 ; lo U 00 /Ylr00cF X <br /> Relin is ad by(Si e): CJ�,at Time Received-by(Signature): Date Time <br /> t 442:4 <br /> Relinquished by gna ure): 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 />