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A & L WESTERN LABORATORIES, INC. <br /> T. 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client e �I,ESNF V (-ONIGlL Phone Cyz�B- /wo <br /> Address P- 0 • L Ox- 37>d CC to: <br /> TL(?L UG/C-___ _/_E zip <br /> Signature of person authorizing work <br /> under terms staled below' <br /> 'Net 30 days. All accounts past due will be subject to interest harges 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 IDNp ANALYSIS <br /> Y�OOL.F Df C'Li2isT BAvr/s7- C'/U.FC co {� <br /> SAMPI, D BY: ( ' tura): Iain- Q� �4 <br /> IV-61* <br /> ers �ry REMARKS <br /> sample � V <br /> Date Time type Sample Location ��QtiF <br /> cue 1tom0. <br /> b u1 /zs'r x // 3 6 R tL X XYY Or LeAc V LWA'rFr< <br /> IP7 Z-A 12ell zD A7,-oe <br /> A/A/ <br /> Re wished by(s' n e): D t Ti a Red by(signature): Date Time <br /> n� / r <br /> iiad7i ? <br /> Relinquished by(Signature): Date Time R ceived 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 />