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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> All <br /> CHAIN OF CUSTODY <br /> Client_ i'�'�1E5T/N/�-- Phone lJ— <br /> Address L 7c��! ~ <br /> CC to: <br /> 12 ZID <br /> Signature of person authorizing work <br /> under terms stated below' ' <br /> :Net 30 days. All accounts past due will be subject to interest chard/es 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 No ANALYSIS <br /> N�2� u/ ptiDS <br /> o <br /> c - <br /> SAMPID BY: ( ture): tain- �k` <br /> r I ers h� REMARKS <br /> sample 1 <br /> Date Time type Sample Location <br /> GrdO Com O. <br /> l�:r 4 y r /Zo 5A a �%4 kEIV <br /> G <br /> Reli ui hed by(signature). D t Time Received by(signature): Date Time <br /> c <br /> Relinquished by(signature): ate 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 />