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tAtgC' <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client (, � Jr-,G/V y C09NS6(L '1/V(_7 Phone <br /> Address y - eu y 'P7,1.4 CC to: <br /> Fa a tQC1__, (A Zip <br /> ri <br /> Signature of person authorizing work <br /> under terms stated below' l� <br /> 'Net 30 days. All accounts past due will be subject to interest cha ges 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 /> PPOJECT ID ANALYSIS/!,, <br /> fiC�Gl r7 d JOL f �A cNo <br /> o ` <br /> SAMPLEtJ BY: (si,9� rel: taro- \�� A,( <br /> e`s Q'4 ;P (_ REMARKS <br /> sample P�' �1 <br /> type Sample Location <br /> Date Time c,+o tomo- <br /> $<q Ir�o 9823 mg :, 7 rZvD k" ` x An1Ps EIZZ) AIVC <br /> Relingri6tried by js�,are): .Date Time Received by(signature): Date Time <br /> i. <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 t <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />