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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 a Modesto, Califomia 95351 • Phone 209-529-4080 <br /> n CHAIN OF CUSTODY <br /> Client �/��Sn/El/ L'O/V1L�GT//t/lj Phone <br /> i <br /> CC to: <br /> I/A2000/! CA Zip �S / <br /> Signature of person authorizing work / <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to Interest cf a1.5% 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 /> PROD T ID No. ANALYSIS <br /> VAti 6 of <br /> Con / <br /> SAMPfD BY: lure): tarn q <br /> e`s AA �� REMARKS <br /> •t./Mlei <br /> Sample Location <br /> Date Time oi*e r <br /> 1, li r I�J 1( PL [C Kurri <br /> 4 6/ X 104A x ?r R <br /> Reli hedb Date <br /> , Time <br /> 00� <br /> Relinquished by(signature): Date Time Received by gnature): Date Time <br /> G <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): DateTime <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />