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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client (, 5�/ � ( i"//UJ uL 7-1 Vf7 Phone <br /> Address <br /> es-�; - � ,��q�q _ CC to: <br /> zip <br /> Signature of person authorizing work 1 �interest <br /> under terms stated below' <br /> -Net 30 days. All accounts past due will be subje1.5% per month. <br /> 'Hazardous materials are the property of the client. The client i responsible.for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID ANALYSIS <br /> ( � cew �k. <br /> Con <br /> SAMPLE BY: (Sig '..e): tan- <br /> f ers a REMARKS <br /> Asamp <br /> �roa Sam le Location <br /> Date Time ciao com,. - t'1 <br /> rJ F 7- 9s' <br /> 715 S r340 Y / ?C X <br /> i v 3e �S�F 7-' X <br /> z lb7� X 7— <br /> Relin hed by(si ':rep. D�te/ Time Received by(signptu re): Date Time <br /> f <br /> Relinquished b. (signature): y 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 /> i <br />