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Al A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Clientn• � <br /> f Phone <br /> Address �- d �.Qy� 2'?9 <br /> CC to: <br /> zip <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. <br /> PROJECT ID /qJ � 1 ANALYSIS li <br /> of <br /> Con- 5 . <br /> SAMP�-E�p BY: i stature): tam <br /> f-kijy'rt ! •� y�;� ers REMARKS <br /> sample �r <br /> type Sample Location \ V <br /> Date Time <br /> m.e c«�n. �( ',/ <br /> Lid '' ()t", �:I% /� k. /LTJ;• W A 7C_ <br /> avM 5J1- <br /> l Rehngo.ished by(sig yr�: Date Time Received by(signature): Date Time <br /> Relinquished byjsignature): Date Time Received by(signature): <br /> 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 />